Multimodal Pain Package vs. Regular Formulation for Pain Management in Ambulatory Spinal Surgery
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ClinicalTrials.gov Identifier: NCT05965492 |
Recruitment Status :
Not yet recruiting
First Posted : July 28, 2023
Last Update Posted : May 3, 2024
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Condition or disease | Intervention/treatment | Phase |
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Spinal Disorder | Drug: Acetaminophen Drug: Celebrex Drug: Gabapentin Drug: Famotidine Drug: Decadron Drug: Oxycodone | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 100 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Optimal Multimodal Pain Management Package Versus Regular Bottled Pain Formulation for Outpatient Use Following Microdiscectomies , Foraminotomies, and Spinal Decompressions: A Randomized Control Trial Comparing Two Strategies |
Estimated Study Start Date : | June 1, 2024 |
Estimated Primary Completion Date : | June 1, 2025 |
Estimated Study Completion Date : | June 1, 2025 |
Arm | Intervention/treatment |
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Active Comparator: Bottled pain formulations Group
Participants in this group will use the standard-of-care medication treatment for ambulatory spinal surgery prescribed to them in different bottles for 7 days.
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Drug: Acetaminophen
Day 1 and Day 2: 1000 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 3000 mg. Day 3 and Day 4: 825 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 2475 mg. Day 5: 500 mg two times a day and 325 mg once a day administered via tablet by mouth for a total cumulative daily dose of 1325 mg. Day 6: 500 mg once a day and 325mg twice a day administered via tablet by mouth for a total cumulative daily dose of 1150 mg. Day 7: 500 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 1000 mg. Drug: Celebrex Day 1: 200 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 400 mg. Day 2 and Day 3: 100 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 300 mg. Day 4: 100 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 200 mg. Day 5: 50 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 100 mg. Not prescribed on Days 6 and 7. Drug: Gabapentin Day 1 and Day 2: 300 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 900 mg. Day 3: 200 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 600 mg. Day 4: 200 mg two times a day and 100mg once a day administered via tablet by mouth for a total cumulative daily dose of 500 mg. Day 5: 100 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 300 mg. Day 6: 100 mg two times a day administered via tablet by mouth for a total cumulative daily dose of 200 mg. Day 7: 100 mg once a day administered via tablet by mouth for a total cumulative daily dose of 100 mg. Drug: Famotidine Day 1- Day 7: 20 mg once a day administered via tablet by mouth for a total cumulative daily dose of 20 mg. Drug: Decadron Day 1: 4 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 12 mg. Day 2: 4 mg two times a day administered via tablet by mouth for a total cumulative daily dose of 8 mg. Day 3: 2 mg two times a day administered via tablet by mouth for a total cumulative daily dose of 4 mg. Not prescribed on Days 4 through 7. Drug: Oxycodone A prescription of oxycodone as per standard of care will be provided to participants in case of breakthrough pain. |
Experimental: Multi-Modal regimen Group
Participants in this group will receive the same drugs used during the standard-of-care treatment for ambulatory spinal surgery. However, the drugs will be prescribed using a simple multimodal medication pre-formulated package for 7 days.
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Drug: Acetaminophen
Day 1 and Day 2: 1000 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 3000 mg. Day 3 and Day 4: 825 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 2475 mg. Day 5: 500 mg two times a day and 325 mg once a day administered via tablet by mouth for a total cumulative daily dose of 1325 mg. Day 6: 500 mg once a day and 325mg twice a day administered via tablet by mouth for a total cumulative daily dose of 1150 mg. Day 7: 500 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 1000 mg. Drug: Celebrex Day 1: 200 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 400 mg. Day 2 and Day 3: 100 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 300 mg. Day 4: 100 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 200 mg. Day 5: 50 mg twice a day administered via tablet by mouth for a total cumulative daily dose of 100 mg. Not prescribed on Days 6 and 7. Drug: Gabapentin Day 1 and Day 2: 300 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 900 mg. Day 3: 200 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 600 mg. Day 4: 200 mg two times a day and 100mg once a day administered via tablet by mouth for a total cumulative daily dose of 500 mg. Day 5: 100 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 300 mg. Day 6: 100 mg two times a day administered via tablet by mouth for a total cumulative daily dose of 200 mg. Day 7: 100 mg once a day administered via tablet by mouth for a total cumulative daily dose of 100 mg. Drug: Famotidine Day 1- Day 7: 20 mg once a day administered via tablet by mouth for a total cumulative daily dose of 20 mg. Drug: Decadron Day 1: 4 mg three times a day administered via tablet by mouth for a total cumulative daily dose of 12 mg. Day 2: 4 mg two times a day administered via tablet by mouth for a total cumulative daily dose of 8 mg. Day 3: 2 mg two times a day administered via tablet by mouth for a total cumulative daily dose of 4 mg. Not prescribed on Days 4 through 7. Drug: Oxycodone A prescription of oxycodone as per standard of care will be provided to participants in case of breakthrough pain. |
- Adherence measured by the self-report medication nonadherence scale [ Time Frame: up to 7 days ]Adherence will be measured using a Likert scale ranging from "never" indicating that the participant followed all instructions and adhered to the medication to "all the time. "indicating that the participant never followed instructions and did not take the medication.
- Satisfaction measured by Satisfaction Likert Scale [ Time Frame: up to 7 days ]Scores range from "0" not satisfied to "10" very satisfied
- Ease of use as measured by Likert Scale [ Time Frame: up to 7 days ]Scores ranges from "strongly disagree to Strongly agree" regarding the ease of use of the medication package.
- Number of pain pills [ Time Frame: up to 7 days ]Count of pills taken by participants
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adults: males or non-pregnant females.
- Patients undergoing ambulatory microdiscectomies, foraminotomies, and spinal cord decompressions requiring pain control analgesics.
Exclusion Criteria:
- Pregnancy
- Active severe liver disease
- Chronic kidney disease 3a-5 (moderate to severe)
- Chronic obstructive pulmonary disease with impaired pulmonary function
- Chronic steroid use
- Chronic opioid use
- Current use of narcotics
- Allergy to sulfonamides
- Allergy to NSAIDs
- Allergy to Aspirin
- Allergy to Tylenol
- Allergy to Gabapentins
- Allergy to H2 blockers (cimetidine, famotidine)
- Allergy to steroid
- Current use of gabapentins for any medical condition
- Inability to be discharged home on the day of surgery
- Inability to swallow pills
- Myasthenia gravis
- History of gastrointestinal ulcers or stomach bleeding
- Have any condition that, in the investigator's opinion, will compromise the well-being of the patient or the study, or prevent the patient from meeting or performing study requirements.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05965492
Contact: Yiliam Rodriguez, MD | (305) 5855456 | yrodriguez4@miami.edu |
United States, Florida | |
University of Miami | |
Miami, Florida, United States, 33136 | |
Contact: Maria Antor 305-587-7677 mantor@miami.edu | |
Principal Investigator: Yiliam Rodriguez, MD |
Principal Investigator: | Yiliam Yiliam, MD | Professor of Clinical |
Responsible Party: | Yiliam Rodriguez, Professor of Clinical, University of Miami |
ClinicalTrials.gov Identifier: | NCT05965492 |
Other Study ID Numbers: |
20230423 |
First Posted: | July 28, 2023 Key Record Dates |
Last Update Posted: | May 3, 2024 |
Last Verified: | May 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | No |
Spinal Diseases Bone Diseases Musculoskeletal Diseases Acetaminophen Celecoxib Oxycodone Gabapentin Famotidine Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Antipyretics Anti-Inflammatory Agents |
Gastrointestinal Agents Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Analgesics, Opioid Narcotics Central Nervous System Depressants Anticonvulsants Anti-Anxiety Agents Tranquilizing Agents Psychotropic Drugs Excitatory Amino Acid Antagonists Excitatory Amino Acid Agents Neurotransmitter Agents Antimanic Agents Anti-Inflammatory Agents, Non-Steroidal |