Does Meloxicam Provide as Much Pain Relief as Opioids After Shoulder Surgery?

Study Overview
=================
Brief Summary
-----------------
The opioid epidemic continues to be a major concern, with orthopedic surgeons being among the top prescribers of opioids. Studies evaluating these practices found that opioids are overprescribed, even for common procedures. Patients undergoing arthroscopic labrum repair of the shoulder were found to have an average of 20 pills left over after surgery. Many strategies have been developed to tackle overprescribing and have found success, including no opioid protocols for carpal tunnel release. The purpose of this study is to examine if meloxicam alone provides similar patient reported outcomes to opioids following arthroscopic labrum repair of the shoulder.

Official Title
-----------------
A Randomized Comparison of Meloxicam to Opioids Following Arthroscopic Labrum Repairs of the Shoulder

Conditions
-----------------
Shoulder Pain

Intervention / Treatment
-----------------
* Drug: Meloxicam 15 mg
* Procedure: Preoperative Interscalene Nerve Block
* Procedure: arthroscopic labral repair


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age ≥ 18 Scheduled for arthroscopic labrum repair of the shoulder Exclusion Criteria: History of opioid, acetaminophen, NSAID or local anesthetic allergy or intolerance, or contraindications to these medications. Currently on long-term preoperative narcotics Scheduled for revision arthroscopic repairs of the shoulder Unable/unwilling to consent for enrollment Unable to complete postoperative surveys History of chronic pain syndromes (fibromyalgia, chronic diffuse MSK pain, etc) Patients under the age of 18 Pregnant or breastfeeding women Scheduled for concurrent procedures

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arthroscopic Labral Repair + postoperative Meloxicam<br>After surgery participants will receive a prescription of 20 pills of 15 mg Meloxicam | Drug: Meloxicam 15 mg<br>* Participants will receive a prescription of 20 pills of 15 mg Meloxicam after surgery<br>Procedure: Preoperative Interscalene Nerve Block<br>* Preoperatively participants will standardly receive an interscalene nerve block<br>Procedure: arthroscopic labral repair<br>* participant will have their standard surgical procedure done<br>|
| Active Comparator: Arthroscopic Labral Repair without Meloxicam<br>After surgery participants will receive a prescription of 20 pills of 5/300 mg vicodin (hydrocodone/acetaminophen) | Procedure: Preoperative Interscalene Nerve Block<br>* Preoperatively participants will standardly receive an interscalene nerve block<br>Procedure: arthroscopic labral repair<br>* participant will have their standard surgical procedure done<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total Analgesic use | Participants will be given a survey asking about number of pills taken | 14 days | 
| Postoperative Pain Control | Measured by the Numerical Rating Scale (NRS) pain score daily after surgery | 14 days |