Non-opioid Based Pain Control After Thyroidectomy

Study Overview
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Brief Summary
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Pain control modalities were evaluated after thyroidectomy.

Detailed Description
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Pain control modalities were evaluated after thyroidectomy. Patients were randomized to one of two pain control regimens. The control group received conventional opioid based post operative analgesia while the test group received an enhanced recovery after surgery (ERAS) based anesthesia with use of acetaminophen and non-steroidal anti-inflammatory drugs for the post operative period with opioid medications available for break through pain only. Pain scores (measured on visual analog scale) and opioid use (measured in morphine equivalent dose) were measured after completion of the operation.

Official Title
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Use of Enhanced Recovery After Surgery (ERAS) in Minimizing Opioid Use for Patients Undergoing Thyroidectomy

Conditions
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Pain, Thyroidectomy

Intervention / Treatment
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* Other: Acetaminophen and hydrocodone based pain control
* Other: Acetaminophen and ibuprofen based pain control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: thyroid disease Exclusion Criteria: currently on opioid pain medications on opioid pain meds in last 30 days cannot take non-opioid medications require more extensive operation than thyroidectomy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized to one of two study groups
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Acetaminophen and hydrocodone based pain control<br>Patients receive acetaminophen 650mg every 4 for pain level 1-3, hydrocodone/acetaminophen 5/325mg every 4 for pain level 4-6, or hydrocodone/acetaminophen 10/650mg every 4 for pain level 7-10 on as needed basis. | Other: Acetaminophen and hydrocodone based pain control<br>* Patients receive acetaminophen 650mg every 4 for pain level 1-3, hydrocodone/acetaminophen 5/325mg every 4 for pain level 4-6, or hydrocodone/acetaminophen 10/650mg every 4 for pain level 7-10 on as needed basis.<br>|
| Experimental: Acetaminophen and ibuprofen based pain control<br>Patients receive standing dose of acetaminophen 650mg every 8 hours and ibuprofen 800mg every 8 hours with alternating ibuprofen and acetaminophen every 4 hours. | Other: Acetaminophen and ibuprofen based pain control<br>* Patients receive standing dose of acetaminophen 650mg every 8 hours and ibuprofen 800mg every 8 hours with alternating ibuprofen and acetaminophen every 4 hours.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| visual analog scale pain level | Pain level from 0 (no pain) to 10 (worst pain imaginable). | 1 hour post operatively | 
| visual analog scale pain level | Pain level from 0 (no pain) to 10 (worst pain imaginable). | 6 hour post operatively | 
| visual analog scale pain level | Pain level from 0 (no pain) to 10 (worst pain imaginable). | 24 hour post operatively | 
| visual analog scale pain level | Pain level from 0 (no pain) to 10 (worst pain imaginable). | 7 days post operatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| opioid use | the dose of opioid received by the patient | with the first 24 hours post operatively |