A Prospective Pilot Study of a Non-Narcotic Post-Operative Course After Colectomy
Analgesia, Post-Operative Pain, Breakthrough Pain
About this trial
This is an interventional treatment trial for Analgesia
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 years of age
- Undergoing elective abdominal colectomy
- Eligible for the Enhanced Recovery After Surgery (ERAS) protocol currently in place for colectomy patients at UVMMC
Exclusion Criteria:
- allergy to any protocol medication
- emergent or urgent bowel surgery
- pre-operative plan for a stoma
- pre-operative diagnosis of rectal cancer (pre-operative diagnosis of rectosigmoid cancer is not necessarily excluded)
- neoadjuvant chemoradiation
- additional malignant disease outside of the colon
- narcotic usage within the three months of scheduled operation date, for more than one week
- chronic pain
- pain score >2 at the initial evaluation for study inclusion
- dementia
Note: Eligibility will be determined by the research coordinator and approved by the surgeon
Sites / Locations
- UVM Medical CenterRecruiting
Arms of the Study
Arm 1
Other
Intervention
Pre-Op Enhanced Recovery After Surgery (ERAS): Gabapentin (900mg capsule), Acetaminophen (1,000mg tablet), Dexamethasone (8mg IV), Granisetron (1mg IV), Morphine (0.15mg Intrathecal) Intraoperatively: Appropriate medications administered at discretion of the treating anesthesiologist during colectomy, with Ketamine use encouraged if not contraindicated. Post-Op (PACU, Onward during inpatient stay): Acetaminophen (Oral) (650mg, q4hrs), Gabapentin (300mg, q6hours), Methocarbamol (750mg, QID), 5% Lidocaine Patch (q12hrs PRN) One time rescue dose (Hydromorphone, Morphine, Oxycodone) available for breakthrough pain during hospital stay (differs from traditional ERAS protocol where medications can be administered as needed). If one-time rescue dose is needed, the covering physician will be notified and can choose to order an appropriate narcotic regimen for remainder of patient's hospitalization. All patients are discharged with a narcotics prescription that they can choose to fill.