Multimodal Analgesia After Shoulder Arthroscopy

Study Overview
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Brief Summary
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This proposal aims to measure the quality of recovery and quality of pain management after shoulder surgery before and after implementation of a multimodal pain protocol.

Detailed Description
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Pain management after shoulder surgery remains to be a major challenge. Reliance on a single agent (most commonly opioids) results in increased incidence of side effects. Multimodal pain management refers to the use of multiple drugs that target different components of pain pathway.

Official Title
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Assessment of Patient Outcomes After Shoulder Surgery After Implementation of a Multimodal Perioperative Management Protocol

Conditions
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Arthroscopy, Analgesia, Shoulder Joint

Intervention / Treatment
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* Combination Product: multimodal perioperative pain protocol (MP3)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients Age 18-80 Speaks and understands the English language Have a phone number Scheduled for shoulder arthroscopy Exclusion Criteria: Inability to read or speak English Individuals outside of age range Pregnant women Persons under the jurisdiction of the Department of Corrections

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pre-MP3<br>before implementation of the multimodal analgesia protocol | |
| post-MP3<br>after implementation of the multimodal analgesia protocol | Combination Product: multimodal perioperative pain protocol (MP3)<br>* administration of gabapentionoid, acetaminophen, non steroidal anti-inflammatory drugs around the clock in addition to the peripheral nerve block offered before surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| QOR-9 | quality of recovery score using the QOR-9 instrument: it is a 9 item questionnaire with each question scoring from 0,1,2 with a total highest possible score of 18 | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| quality of pain management | quality of pain management was measured using the revised american pain society patient oriented outcome questionnaire (APS-POQ-R). The questionnaire measures quality of pain management in 5 domains: 1- pain intensity 2- pain interference with activity and sleep 3- emotional side effects of uncontrolled pain ( affective scale). 4- patient perception of their pain management 5-side effects of pain treatment some questions answers are on a scale from 0-10. Ten is the maximum score and zero is the minimum score. other questions are listed as percentage with increments of 10% at a time (0%,10%, 20%, 30%..etc). each item/question is reported individually | 24 and 48 hours | 
| amount of opioids | amount of opioids used converted to mg equivalent of oxycodone | 24, 48 and 72 hours after surgery | 
| QOR-9 | quality of recovery score using the QOR-9 instrument: it is a 9 item questionnaire with each question scoring from 0,1,2 with a total highest possible score of 18 | at 48 hours and 72 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multimodal analgesia, quality of recovery, quality of pain management