The objective of this study is to evaluate narcotic use after implementation of a Non-Opioid Multimodal Pain (NOMO) protocol in patients who are undergoing a urogynecologic procedure. The study will also evaluate secondary outcomes, including: post-operative pain rating, length of hospital stay, postoperative antiemetic use, bladder catheterization at discharge, number of post-operative phone calls, and rate of reported side effects of opioid use (nausea/constipation). Study participants will be asked to utilize the validated Brief Pain Inventory (appendix A) scale to assess post-operative pain levels. Based on inpatient post-operative opioid use and number of opioid pills prescribed at discharge, an attempt will be made to develop an algorithm for recommended opioid prescribing patterns.
The objective of this study is to evaluate narcotic use after implementation of a Non-Opioid Multimodal Pain (NOMO) protocol in patients who are undergoing a urogynecologic procedure. NOMO protocols seek to reduce the opioid usage for patients in the postoperative period. Patients will receive multiple pain medications (usually referred to as a "pain cocktail") that work on various pain receptors throughout the body. These medications are approved for pain control; but they have few side effects and less addictive properties. The study will also evaluate secondary outcomes, including: post-operative pain rating, length of hospital stay, postoperative antiemetic use, bladder catheterization at discharge, number of post-operative phone calls, and rate of reported side effects of opioid use (nausea/constipation). Study participants will be asked to utilize the validated Brief Pain Inventory (appendix A) scale to assess post-operative pain levels. Based on inpatient post-operative opioid use and number of opioid pills prescribed at discharge, an attempt will be made to develop an algorithm for recommended opioid prescribing patterns.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
10
Standard weight-based ketamine bolus (0.5 mg/kg) at procedure start, no Opioid rescue medications
Prisma Health - Upstate
Greenville, South Carolina, United States
Morphine Milligram Equivalents Used During Inpatient Stay
Total morphine milligram equivalents calculated for each patient during their stay.
Time frame: from immediately postoperative through discharge or 4 weeks, whichever comes first
Passage of Voiding Trial
percentage of patients who pass voiding trial on POD#1
Time frame: from immediately postoperative through discharge or 4 weeks, whichever comes first
Anti-emetic Use
Did the patient require anti-emetics in the post-operative period
Time frame: postoperative day 1 through day of discharge from hospital; all patients were dischard on post-op day 1
Patient Pain Score
Evaluated via the "Brief Pain Inventory (Short Form)"; rate pain on scale 0-10, 10 being worst
Time frame: postoperative day 7
Prescription for Opioid at Discharge
Did the patient require a narcotic prescription
Time frame: postoperative day 2 through postoperative day 7
Length of Hospital Stay
The average number of days patients were admitted as inpatient.
Time frame: postoperative day 1 through discharge or 4 weeks, whichever comes first
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