Conditions: Cervical Cancer Uterine Endometrial Cancer Ovarian Cancer
Keywords: laparotomy hysterectomy
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 103
Healthy volunteers: yes

Brief summary:
Over 600,000 hysterectomies are performed annually in the United States. Despite increasing use of less invasive approaches, the majority of hysterectomies are still performed via traditional laparotomy, which can be associated with generally slower recovery and longer lengths of post-operative hospitalization. Rapid Recovery Protocols (RRP) seek to optimize post-surgical morbidity outcomes by returning a patient to normal physiology as quickly as possible following surgery.

Detailed description:
Subjects will be randomly assigned to one of two groups: Rapid recovery protocol (regional anesthesia, pain control options with emphasis on nonsteroidal anti-inflammatory drugs (NSAIDS) over narcotic pain medications, early ambulation, and early enteral feeding) or standard of care (traditional laparatomy and supportive care).

Arms:
arm 1: Patients undergoing standard anesthesia and standard exploratory laparotomy. Treatment will be per your surgeon's routine standards. arm 2: Protocol for "rapid recovery laparotomy" procedure involves pre-operative counseling, the use of regional anesthesia (spinal or epidural pain management rather than intravenous narcotics), post-operative use of non-steroidal anti-inflammatory drugs, early eating after surgery, early walking, and certain goals for discharge from the hospital.

Interventions: intervention 1: Laparotomy intervention 2: intravenous narcotics intervention 3: standard anesthesia intervention 4: regional anesthesia intervention 5: Non-steroidal anti-inflammatory drugs
Intervention descriptions: intervention 1: Exploratory surgery for gynecologic diagnosis.Involves pre-operative counseling, the use of regional anesthesia (spinal or epidural pain management rather than intravenous narcotics), early eating after surgery, early walking, and certain goals for discharge from the hospital intervention 2: given for pain management after surgery per physician orders intervention 3: inhalant or intravenous during surgery intervention 4: given by spinal or epidural infusion intervention 5: given for pain management after surgery

Protocol document: