Efficacy of Opioid-limiting Pain Management Protocol in Men Undergoing Urethroplasty
Pain, Postoperative, Urethral Stricture
About this trial
This is an interventional treatment trial for Pain, Postoperative focused on measuring anterior urethroplasty, pain management, postoperative pain, opioid use
Eligibility Criteria
Inclusion Criteria:
- Men greater than 18 years of age who are scheduled for anterior urethroplasty surgery
Exclusion Criteria:
- Any patient not classified as a II or III on the American Society of Anesthesiologists (ASA) physical status classification system.
- General anesthesia or neuraxial anesthesia with epidural used as anesthetic techniques
- Allergy/intolerance to local anesthetic or steroids
- Pre-existing neurological and/or anatomical deficit that would preclude regional block
- Coexisting coagulopathy such as hemophilia or von Willebrand Disease
- BMI greater than 40 or less then 20
- History of intravenous drug or opioid abuse
- History of opioid use within a week prior to urethroplasty
- History of any chronic pain syndrome
- Posterior urethroplasty
- Patients with chronic kidney disease
- Patients allergic to NSAIDs
- Patients requiring more than one buccal graft harvest
- Patients with graft urethroplasty with site other than buccal
- Patients with a history of previous urethroplasty
Sites / Locations
- University of Alabama of Birmingham
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Standard Protocol
Enhanced Recovery Protocol
Patients will receive the historical standard for pain management, which may include narcotics during and after surgery. Postoperative prescriptions ibuprofen 800 mg, and acetaminophen 1000 mg to be taken on a scheduled basis then as needed. Another prescription for oxycodone will be given to be used only if needed.
A combination regimen of acetaminophen, Celebrex and gabapentin pre-op, with 30 mL of 0.5% bupivacaine and 4 mg of dexamethasone given as a perineal nerve block at the time of urethroplasty surgery. Narcotics will be administered judiciously and ass seen fit by the anesthesia and/or surgical teams. Postoperative prescriptions ibuprofen 800 mg, and acetaminophen 1000 mg to be taken on a scheduled basis then as needed. Another prescription for oxycodone will be given to be used only if needed.