Multimodal Pain Management After Robotic-Assisted Total Laparoscopic Hysterectomy

• Status: Recruiting
• Trial end date: 2023-01-01
• Target enrollment: 0
• Participant gender: Female

Summary

Hysterectomy is the most common major gynecologic surgery performed in the US and is performed for a variety of indications including malignancy, pelvic mass, endometriosis, leiomyoma, and pelvic organ prolapse. The traditional regimen for pain control post-operatively is opioid-based however in light of the opioid epidemic, a transition to non-opioid pain medication regimens is desired by both physicians and patients alike. The goal of this study is to develop a multimodal non-opioid pain medication regimen that minimizes postoperative opioid use after robotic assisted total laparoscopic hysterectomy. Historical controls from Jan 1, 2017 to Jan 1, 2020 will be compared to our treatment arm from October 15, 2020 to October 15, 2022. Included in our treatment protocol is paracervical block and local ropivacaine at abdominal incision sites at surgical start, gabapentin and acetaminophen preoperatively and postoperatively, and celecoxib postoperatively. Opioid use will be measured 0-3 h postop and 3-24h postop (as surrogate marker of time spent recovering in the Post Anesthesia Care Unit (PACU), and during the full length of hospital stay); pain scores will additionally be measured.

• Phase: Phase 3
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: State University of New York at Buffalo
• Treatments: Acetaminophen; Anesthetics; Anesthetics, Local; Celecoxib; Gabapentin; Hydromorphone; Ketorolac; Oxycodone; Ropivacaine

Criteria

Inclusion Criteria:

• Women undergoing robotic-assisted total laparoscopic hysterectomy, with or without bilateral salpingo-oophorectomy

• Uterine weight ≤325 grams

Exclusion Criteria:

• contraindication to any study medications (h/o gastric bypass, gastric ulcers, CKD)

• current opioid prescription