Ensayos clínicos

The purpose of this study is to personalize pain medication regimens leveraging sensor-driven, digital ecosystems that can recognize subtle markers of pain and over-medication. Multiple sensors will be used to measure the autonomic features of pain and overdose and thereby build a composite and objective profile to determine pain needs and indicators of safety.

The researchers are trying to determine pain medication consumption in the first 24 hours after surgery in patients given the standard continuous infusion of local anesthetic versus patients given the same total dose via programmed intermittent dosing. Both groups will receive the option of patient controlled pain medication as well as the same dose of pre-programmed pain medication. The only difference is the rate of administration: continuous vs. hourly intervals.

The purpose of this study is to assess factors affecting opioid prescribing variability among surgical and primary care providers, utilizing a qualitative approach, and to identify factors influencing the transition (i.e., “handoff”) of opioid prescribing from surgical providers to primary care providers in the postoperative period for a subset of patients receiving prolonged postoperative opioid use, utilizing qualitative assessment.

The purpose of this study is to measure the effectiveness of ketamine in reducing chronic post-mastectomy pain.  

The purpose of this study is to evaluate the effect of using ice packs on the abdomen immediately after laparoscopic hysterectomy surgery on pain control and narcotic pain medication use.

The purpose of this study is to assess analgesia effectiveness between liposomal bupivacaine single injection interscalene blockade vs. continuous interscalene nerve block for patients undergoing primary total shoulder arthroplasty. It also aims to include pain scores and opioid consumption at pre-defined time intervals, peripheral nerve block complications, length of hospital stay, and postoperative follow-up up to 7 days after surgery.

The purpose of this study is to record the visual analog pain score (VAS) score given to the surgical team by the patient and compare this to the value given to the nursing staff. The patients will be blinded to the study in order to prevent bias.

The purpose of this study is to assess high ankle block versus regional block for acute pain control after ankle surgery.

After surgery to remove the eye, either by enucleation or evisceration, patients have variable levels of pain for several postoperative days. Some patients have almost no discomfort while others require significant amounts of oral narcotics and report pain of 10 out of 10 on a numerical rating scale. The current operative standard is to infiltrate the eye socket with 0.5% bupivacaine during surgery leading to several hours of postoperative analgesia. In 2011, Pacira Pharmaceuticals released a bupivacaine liposomal injectable suspension (Exparel, 1.3%) which offers sustained release of bupivacaine giving postoperative pain control for up to 72 hours. This medication has ...

This study is prospective, randomized trial in which EXPAREL TAP block is compared to standard IT opioid administration, in relieving postoperative pain, decreasing length of stay, and use of narcotic medication.

The purpose of this study is to evaluate the impact of education for proper disposal and rate of utility of disposal bag.

In this study we will study to see if a single set of unilateral intercostal nerve blocks provides pain control as effectively as a continuous thoracic epidural, and will a lower incidence of side effects. Although the anesthesiologists involved in providing care for patients having thoracotomy incisions at SMH are experts at placing thoracic epidural catheters, this study will attempt to show that a less technically challenging procedure done by surgeons intraoperatively can provide comparable pain relief.

The purpose of this study is to develop and pilot test an electronic patient-reported outcome (ePRO) monitoring and reporting tool for use in post-surgical pain self-management.

The purpose of this study is to evaluate the impact of patient input on opioid prescribing and overall opioid use following gynecologic surgery.

The purpose of this study is to test an automated alert function of an ePRO monitoring and reporting tool for use in post-surgical pain self-management.

Pain control is a key for successful postoperative recovery after colorectal (i.e., involving large bowel or rectum) surgery. Spinal analgesia has been shown to be safe and efficacious and commonly used in clinical practice. It involves administering pain medicine through a small needle in the lower portion of a patient's back. The pain medications most commonly used for spinal analgesia are morphine and hydromorphone. Despite their frequent use, the dose which achieves best pain control while reducing unwanted adverse effects has not been determined. We are attempting to determine the optimal dose of spinal morphine and hydromorphone in patients undergoing minimally-invasive (i.e., surgery performed through small entry sites and using cameras) ...

The purpose of this study is to assess postoperative pain in patients who received pudendal block with quantitative outcomes charted in medical records such as total amount of analgesics received, intraoperative vitals, number of days till mobile, and patient reported pain scale.

The purpose of this study is to investigate non-opioid alternatives to post-operative pain management following hip arthroscopy. This study aims to compare traditional narcotic intervention with a novel non-opioid pain regimen. 

1. To determine utilization patterns of narcotic pain medication postoperatively for patients recovering from a general surgery or subspecialty procedure
2. To compare the outcomes of patients’ pain medication regimens with current non-standardized prescribing patterns versus an evidence-based standardized prescribing regimen once the initial needs assessment is complete
   1. To characterize patient satisfaction with postoperative narcotic pain regimens
   2. To describe side effects experienced from using narcotic pain medications

The purpose of this study is to evaluate the effectiveness and ease of use of Transcutaneous Electrical Nerve Stimulation (TENS) in patients who have had a video assisted thoracotomy surgery.

The purpose of this study is to determine the effects of liposomal bupivacaine vs lidocaine/bupivacaine mixture in patients’ undergoing surgical placement of a penile prosthesis.

The purpose of this study is to determine if peripheral nerve block with liposomal bupivacaine in combination with standard bupivacaine will prolong the duration of block, improve pain scores, and decrease opioid utilization in the post-operative period when compared to peripheral nerve block with standard bupivacaine alone.

The purpose of this study is to evaluate the impact of preoperative implementation of cognitive behavioral therapy (CBT) on patient pain perception and opioid use in patients undergoing elective colorectal surgery. Implementing pre-operative CBT will decrease patient’s pain perception, improve patient’s post-operative recovery satisfaction, and reduce use of opioid medications.

The purpose of this study is to determine the effectiveness of a pre-operative and post-operative psychosocial intervention to improve acute pain outcomes and reduce opioid use in adolescents undergoing major musculoskeletal surgery.
 

The prevalence of chronic pain following total knee replacement has been under studied.  In recent years, the perioperative use of multimodal analgesic strategies including regional anesthetic techniques has substantially improved early postoperative pain management. However, it is not clear that these improvements in perioperative care have reduced the frequency of chronic pain post-total knee replacement.  This study will conduct a cross sectional study to determine the prevalence of chronic knee pain following total knee replacement up to 5 years postoperatively.  This study will also identify risk factors, such as smoking, depression, and pain problems elsewhere as predictors of chronic knee pain after knee ...

The purpose of this study is to compare two methods of postoperative pain management for patients who have undergone total knee replacement surgery.

The purpose of this study is to compare the use of ultrasound guidance and nerve stimulator guidance with a popliteal (knee) nerve block for postoperative pain control.

The purpose of this study is to explore the clinical impact of pain management education using a mobile web-based education delivery system compared to standard education delivery. This study seeks to understand the difference between two different education delivery methodologies and the effect on the postoperative pain experience, including participation in treatment plan, knowledge, pain outcomes, and opioid requirements in patients undergoing major hip (THA) and knee (TKA) arthroplasty. It is hypothesized that a real-time, interactive, mobile education system will demonstrate improved pain associated outcomes and higher patient participation when compared to the current standard education delivery method.

The purpose of this study is to assess the safety of Dextenza compared to an active control, prednisolone acetate suspension, for the treatment of postoperative pain and inflammation following ocular surgery for pediatric cataract.

The purpose of this study is to evaluate the safety of TRV130 for treatment of patients who have moderate to severe pain caused by medical conditions or surgery, and who require IV opioid therapy.

The purpose of this study is to determine if CBD oil has any effect on decreasing postoperative pain control following ureteroscopy for urinary stone disease, and to determine if CBD oil has any effect in decreasing the amount of postoperative opioids (commonly used drug) used by patients after undergoing ureteroscopy for urinary stone disease.

The purpose of this study is to compare the postoperative pain levels both in the hospital setting as well as daily for two weeks following discharge between patients in the opioid treatment group and those in the non-opioid treatment group.

The primary objective of this study is to evaluate sternal bone healing following a full median sternotomy versus standard of care for sternal closure with wire cerclage. Additional outcomes on post-operative pain and analgesic usage, patient function and quality of life, and complications will also be collected. A health economics study will also be conducted, in which cost and billing data will be collected from sites participating in this clinical study.

Opioid medications such as morphine, hydrocodone and oxycodone are standard for treating pain after surgery, however there are disadvantages. Because of the way opioids work, gastric bypass patients may have an increased risk of having sedation or problems with breathing. In patients with sleep apnea, opioids may increase the risk of severe apnea. Ketamine is an alternative pain medicine that can be used to treat pain after surgery and may have fewer effects on breathing. Using ketamine as part of the regimen may be a better choice for laparoscopic gastric bypass patients. This study is being done to find out ...

The purpose of this study is to investigate whether the injection of a long active liposomal bupivacaine product, currently approved for injection into operative sites for post-surgical pain, is an acceptable treatment for costal cartilage harvest site pain when injected into the surgical site after costal cartilage harvest in comparison to the standard treatment of 1% lidocaine with 1:100:000 of epinephrine at the surgical site. 

The purpose of this study is to determine whether the routine use of belladonna and opium suppositories will improve pain control following vaginal surgery.

The purpose of this study is to compare total amount of opioid use in the first 72 hours following surgery, calculated as morphine equivalents using standard conversion.

Secondary outcome measures include pain scores, non-opioid medication use, nausea, vomiting, length of hospital stay, and patient satisfaction of pain management.

This study aims to compare postoperative pain levels between three (3) treatment groups, using the Numerical Rating Scale (NRS).

The purpose of this study is to confirm the efficacy of the Barricaid® when used as an adjunct to a primary lumbar limited discectomy, to limited discectomy alone, with regard to preventing reherniation and the recurrence of pain or dysfunction in a US population.

The primary purpose of this study is to compare postsurgical opioid consumption through 72 hours postsurgery in patients receiving local infiltration analgesia (LIA) with EXPAREL and bupivacaine HCl (EXPAREL group) with that of patients receiving standard of care (SOC) (control group) in adult subjects undergoing posterior lumbar spine surgeries where both groups are receiving a multimodal pain regimen.

The purpose of this study is to determine if open surgical resection is superior to thoracoscopic resection for thoracic event-free survival (tEFS) in patients with resectable oligometastatic pulmonary osteosarcoma.

Furthermore, to determine if open surgical resection is superior to thoracoscopy for event free survival (EFS), for overall survival (OS), and if thoracoscopy is superior to open surgical resection for postoperative pain interference in patients with resectable oligometastatic pulmonary osteosarcoma.

The purpose of this study is to access the effectiveness of over-the-counter analgesics in the management of post-operative pain after hand soft tissue surgical procedures.  These procedures would include carpal tunnel syndrome, trigger finger release, and first compartment releases in DeQuervain's syndrome.

The purpose of this study is to observe changes in bowel pattern based on gum-chewing, examine bowel function after anterior lumbar interbody fusion, measure length of time to return of bowel function after anterior lumbar interbody fusion, compare return of bowel function in patients who chew gum and patients standardized to usual post-operative care, measure the hospital length of stay amongst study groups, and measure post-operative pain amongst study groups.

This study will utilize Rasch analysis to study the construct validity and reliability of five shoulder-related patient-reported outcome measures in patients reporting shoulder impairment following surgery for head and neck cancer.