Urolithiasis Clinical Trial
Official title:
Evaluating Post-operative Pain Management Efficacy of Intra Nasal Ketorolac in Ambulatory Urological Surgeries-A Randomized Double-blinded Placebo Controlled Study
Despite an overall reduction in the perioperative complication rate, post operative pain management after ureteroscopic removal of stones (URS) remains a major factor delaying discharge of patients. The investigators hypothesize that perioperative usage of intranasal ketorolac will provide a reduction in post operative opioid requirements, better post operative pain control, higher anesthesia satisfaction and faster recovery.
The prevalence and incidence of urolithiasis, or kidney stone disease, are increasing in the
general population. Life-time incidence of urolithiasis is estimated to be between 5%- 12%.
The treatment of kidney stones depends on stone type and size, symptom severity, and the
presence of obstruction.
URS is a common ambulatory procedure as improved technological advances and increased
clinical utilization have helped decrease postoperative complications. Despite an overall
reduction in the perioperative complication rate, post operative pain management after URS
remains a major factor delaying discharge of patients.
Post operative pain after URS is usually treated with opioids and non steroidal anti
inflammatory drugs. Intranasal ketorolac (SprixTM) is an FDA approved pain formulation for
short term management (5 days) of moderate to moderately severe pain that requires analgesia
at the opioid level. The efficacy of intranasal ketorolac formulation was demonstrated in
placebo-controlled studies in patients following major surgeries.
The primary objective of the study is to evaluate the role perioperative usage of single-dose
of intranasal ketorolac on immediate post operative opioid requirements. Secondary objectives
of the study are to (a) evaluate the post operative pain score 30 minutes after surgery, 1
hour after surgery, and 2 hours after surgery, (b) find the incidence of immediate (until
discharge) and 24hrs post operative side effects in the target population, (c) find the level
of anesthesia satisfaction in the target population, (d) find the time to discharge in the
target population, (e) compare the two groups post anesthesia discharge score.
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