Effect of Perioperative Acetaminophen Dosing on Patients Undergoing Surgical Treatment of Basilar Thumb Arthritis

Phase 4TerminatedNCT05556356

Indiana Hand to Shoulder Center23 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Enrollment

Conditions

Carpometacarpal Osteoarthritis

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Visual Analogue Scale (VAS)

Patients report pain on a scale of 0 (no pain) to 100 (worst possible pain)

Time frame: 2 weeks

Number of Narcotic Pills Used