The study aims to compare the incidence of side effects caused by Oxycodone and Hydromorphone.
Nausea and vomiting in the post-operative period is considered strongly undesirable by patients and has adverse effects on recovery from outpatient procedures, contributing significantly to delays in discharge from recovery. A know major contributor to the occurrence of post-operative nausea and vomiting is the use of opiate medications which are the cornerstone of post-operative pain management. The investigators hypothesize that the occurrence of this side-effect is different between patients prescribed oxycodone and those receiving hydromorphone for acute pain management after total hip replacement surgery. This investigation is a randomized, double-blind, head-to-head comparison to equipotent administration of oxycodone vs. hydromorphone to determine whether such a difference exists.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
200
Patients will receive oxycodone 10mg (5mg if \> 65) every 2 hours based on an equianalgesic dose calculation. As per routine practice, the dose will be titrated according to the patient's pain at the discretion of the Acute Pain Service physician who will not be blinded to group allocation.
Patients will receive an initial dose of hydromorphone 2mg (1mg if \> 65) every 2 hours as needed based on an equianalgesic dose calculation. As per routine practice, the dose will be titrated according to the patient's pain at the discretion of the Acute Pain Service physician who will not be blinded to group allocation.
Toronto Western Hospital
Toronto, Ontario, Canada
The occurrence of postoperative nausea
The incidence and severity of nausea will be recorded twice daily up to 72 hours post-operatively
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 72 hours
Daily pain scores
Pain scores (0-10) will be recorded twice daily until 72 hours post-operatively
Time frame: 72 hours after surgery
Incidence of opioid related itching
The presence or absence of the opioid related side effects will be recorded twice daily until 72 hours post-operatively
Time frame: 72 hours after surgery
Incidence of delirium
The presence of delirium will be recorded until 72 hours post-operatively
Time frame: 72 hours after surgery
Cumulative in-hospital opioid consumption
Total in-hospital opioid consumption in morphine equivalent doses will be calculated for the first 72 hours post-operatively
Time frame: 72 hours after surgery
Use of anti-nausea medications
The number of administrations and doses of anti-nausea medications will be evaluated until 72 hours post-operatively
Time frame: 72 hours after surgery
Cumulative drug costs per patient
The cumulative drug cost based on all anti-nausea and analgesic medications administered will be calculated for the first 72 hours post-operatively
Time frame: 72 hours after surgery
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Post-operative admission duration
The number of post-operative days required for admission will be assessed. Duration is to be an expected average of 72 hours
Time frame: Total admission duration, an expected average of 72 hours