Carpometacarpal Osteoarthritis
Conditions
Brief summary
Basilar thumb arthritis is a common problem that affects 7% of men and 15% of women. It is regarded as one of the more painful procedures commonly performed by hand surgeons. Opioid overuse and diversion are significant problems in the country that contribute to opioid addiction as well as deaths from opioid overdose. Prior studies have examined the effect of different nerve block compositions on perioperative and postoperative analgesia, but none have looked at perioperative loading analgesia. We will attempt to address this problem by exploring alternative analgesia regimens to decrease opioid prescribing after 1st carpometacarpal (CMC) joint arthroplasty.
Interventions
DRUGAcetaminophen
pre-operative acetaminophen (1000mg)
OTHERPlacebo: Multivitamin
pre-operative Multivitamin
Sponsors
Indiana Hand to Shoulder Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Caregiver)
Masking description
Participants unblinded following final data collection.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (18 years of age or older) * Patients presenting with symptomatic 1st CMC arthritis with or without scaphotrapeziotrapezoid arthritis * Eaton Classification stage II, III, or IV OA of the first CMC joint based on xrays * Patients who plan to undergo a ligament reconstruction and tendon interposition (LRTI) or thumb suspensionplasty procedure within 6 months of enrolling to study * Bilateral thumbs included
Exclusion criteria
* \<18 years age * Prior surgical history of ipsilateral 1st CMC arthroplasty or procedures involving thumb CMC joints * Prior ipsilateral tendon rupture or ipsilateral peripheral nerve palsy * History of opioid dependency or current chronic opioid use * Contraindication to acetaminophen use * Contraindication to NSAID use * Contraindication or known allergy to peripheral nerve blockade, including coagulopathy * Contraindication to supraclavicular block due to anatomic variability or inability to tolerate phrenic nerve blockade. * Contraindication to multivitamin use * Liver dysfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale (VAS) | 2 weeks | Patients report pain on a scale of 0 (no pain) to 100 (worst possible pain) |
| Number of Narcotic Pills Used | 2 weeks | Number of Narcotic Pills Used |
Countries
United States
Outcome results
None listed