Multimodal Pain Management after Robotic-Assisted Total Laparoscopic Hysterectomy
This study enrolls women who will be having a hysterectomy. Our goal is to create a non-opioid pain medication plan that will make opioid pain medications less needed after surgery.
Participants in this study will have education about their surgery before the operation and will learn about ways to minimize opioid use. Non-opioid pain medications will be given before, during and after surgery. An opioid medication will be available post op in case there is pain that is not helped by non-opioid medications. During the study, you will complete surveys about your pain and medication usage. This study takes place at Millard Fillmore Suburban hospital.
To create a multimodal pain regimen for those undergoing gynecologic robotic surgery at an academic teaching institution with the goal of minimizing post operative opioid usage. We hope to create a protocol that is feasible for implementation in a majority of gynecologic practices. 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 many patients. 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 July 1, 2020 to July 1, 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 ketorolac and celecoxib postoperatively. Opioid use will be measured at hour 0-3 post-operative and hour 3-24 post-operatively; pain scores will additionally be measured.
Adults ages 18+.
Women undergoing a robotic hysterectomy who do not have current opioid prescription or current opioid addiction.
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