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Exparel Injection Effect on Postoperative Opioid Usage

2019-09-17 02:47:41 | BioPortfolio

Summary

The question proposed by this study, is one of patient outcomes. Does intraoperative injection of Exparel decrease postoperative use of opioid pain medications in patients undergoing thyroid and parathyroid surgery? The trial seeks to assess the effect that Exparel has on postoperative pain control.

Description

Patients will be identified in clinic as good candidates for surgical intervention based on current standard of care. Once participants are consented, they will be randomly placed into one of three categories. The first category being patients undergoing surgery with local injection of lidocaine and epinephrine as is current practice. The second category of patients will undergo surgery with local injection of bupivacaine HCL and epinephrine preincision. The third group will undergo surgery with local injection of lidocaine and epinephrine preincision and Exparel postincision. As stated above, all patients will undergo surgery as planned, which will be standard of care, with the exception of the local anesthetic and timing of the injection. Postoperatively, patient's pain scores and opioid usage will be evaluated. Patients will be monitored by either using the patient's electronic medical record or by a pain journal that will be provided to the patients. The patients will record their pain using a scale of 1-10 with the FACES scale, as well as medication usage. Patients will return to their first postoperative appointment to further discuss their pain levels as well as medication usage. An ANOVA test will be used to determine if there is a significant difference in the amount of opioids taken postoperatively, in oral morphine equivalents, between these three groups. Opioid usage will then be compared between participants in different categories of local anesthetic to determine if there is an effect of postoperative opioid usage between different anesthetics.

Study Design

Conditions

Thyroid

Intervention

Lidocaine Epinephrine, Bupivacaine Hydrochloride-EPINEPHrine, Lidocaine Epinephrine, Bupivacaine Hydrochloride-EPINEPHrine

Status

Not yet recruiting

Source

University of Missouri-Columbia

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-09-17T02:47:41-0400

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Medical and Biotech [MESH] Definitions

A racemic mixture of d-epinephrine and l-epinephrine.

Product of epinephrine O-methylation. It is a commonly occurring, pharmacologically and physiologically inactive metabolite of epinephrine.

A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine.

A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)

Biological adaptation, such as the rise of EPINEPHRINE in response to exercise, stress or perceived danger, followed by a fall of epinephrine during RELAXATION. Allostasis is the achievement of stability by turning on and turning off the allostatic systems including the IMMUNE SYSTEM; the AUTONOMIC NERVOUS SYSTEM and NEUROENDOCRINE SYSTEMS.

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