Pain, Postoperative Clinical Trial
Official title:
A Prospective, Double-blind, Randomized Pilot Study Evaluating the Effects of Toradol and Lyrica Verses Placebo for Pain Control After Donor Nephrectomy (TORPEDO)
The investigators will assess how the use of toradol and pregabalin affects return to bowel function and see if there is a difference in length of hospital stay. Narcotic use can affect bowel function so the investigators hypothesize that use of Toradol will decrease delayed bowel function and aid in a patients discharge and reduction of hospital stay.
Perioperative pain management is a significant challenge following surgery. Many pathways
contribute to perioperative pain, including nociceptive, inflammatory, and neuropathic
sources. Although opioids have long been a mainstay for perioperative analgesia, other
non-opioid therapies have been increasingly used as part of a multimodal analgesic regimen to
provide improved pain control while minimizing opioid-related side effects
TORADOL (ketorolac tromethamine), is a nonsteroidal anti-inflammatory drug (NSAID), is
indicated for the short-term (up to 5 days in adults), management of moderately severe acute
pain that requires analgesia at the opioid level.
Anecdotal evidence has shown that the use of Toradol (Ketorolac) is safe in renal surgery
patients. The study team aims to further evaluate this in a pilot study specifically in the
population of patient who have donated their kidney in live kidney transplants. The study
team will assess how the use of toradol affects return to bowel function and see if there is
a difference in length of hospital stay. Narcotic use can affect bowel function so the
investigators hypothesize that use of Toradol will decrease delayed bowel function and aid in
a patients discharge and reduction of hospital stay. The study team will assess differences
in visual analog pain scores and total narcotic consumption, whereas secondary endpoints of
urine output, serum creatinine and hemoglobin levels to assess for efficacy and safety.
Pregabalin is prescribed for neuropathic pain. In many studies, preoperative administration
of pregabalin reduced postoperative morphine consumption and early postoperative pain.
There will be two arms of the study including:
Arm 1 (pure placebo group): Placebo oral preop then Saline placebo IV x 1 in the OR, then
saline placebo IV every 6 hours for 7 doses.
Arm 2: Pregabalin 75mg oral preop, then Ketorolac 30 mg IV x 1 in the OR, then ketorolac 15
mg IV every 6 hours for 7 doses.
Toradol and Lyrica will be used consistent with its FDA approval in terms of dosing, route of
administration, etc.
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