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CompletedNCT05393414Updated May 26, 2022

Efficacy of NSAID and Acetaminophen in the Control of Post-Operative Pain in Patients Undergoing Total Knee Replacement

An interventional study of Opioid based protocol and Opioid sparing protocol in Pain, Hispanics and Opioid Use, sponsored by University of Puerto Rico. Completed at 1 site in Puerto Rico. Open to participants aged 18 Years to 110 Years. Per ClinicalTrials.gov, last updated 2022-05-26.

Sponsored by University of Puerto Rico · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 2 years 5 months after the study started (first participant enrolled Nov 2019, registered May 2022).
Phase
Not applicable
Study type
Interventional
Enrollment
81
Allocation
Randomized
Ages
18 Years to 110 Years
Sex
All
01

Study summary

An alternate perioperative pain control protocol composed of intravenous ketorolac and oral acetaminophen for patients who underwent total knee replacement was designed with the aim to determine its efficacy when compared to pain control with intravenous morphine and oral oxycodone combined with acetaminophen. In addition, the study will evaluate the differences and similarities in the Hispanic population that could predict protocol efficacy.

Read the detailed description

Acute pain after a surgical procedure may occur secondary to trauma from the procedure itself or from procedure-related complications. Appropriate peri-operative acute pain management is an important phase of patient's recovery since it's under-treatment can lead to adverse outcomes such as: thromboembolic and pulmonary complications, additional time spent in an intensive care unit or hospital, hospital readmission for further pain management, needless suffering, impairment of health-related quality of life, and development of chronic pain. Furthermore, it's over-treatment with opioid medications is associated with an increased risk of thromboembolic, infectious and gastrointestinal complications as well as increased length of hospital stay, cost of care and risk of opioid addiction.

Perioperative administration of intravenous (IV) non steroidal anti-inflammatory drugs (NSAID), such as ketorolac, has been shown to effectively decrease opioid requirements and pain levels while demonstrating tolerable side effects. Its use after total knee replacement has been associated with a 27% decrease in the use of morphine. When NSAID is combined with acetaminophen 1000mg every six hours, an additional benefit in terms of improved pain scores on post-operative day three was shown in patients who underwent total hip or knee arthroplasty. Therefore, the purpose of this study is to provide an effective alternative for pain management in Hispanic patients who underwent total knee replacement and evaluate the role of ketorolac and acetaminophen.

02

Conditions studied

  • Pain
  • Hispanics
  • Opioid Use
  • Multimodal Analgesia
  • Total Knee Arthroplasty

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Keywords

  • Total Knee Arthroplasty
  • Postoperative Pain
  • Opioid Use
  • Hispanics
  • Clinical Outcomes
  • Multimodal Analgesia
03

In context

Pain, Postoperative

5,093 studies on the registry are indexed under Pain, Postoperative; 1,140 are open to participants now.

This study's enrollment of 81 is close to the median of 75 across 4,344 interventional studies indexed under Pain, Postoperative.

Browse Pain, Postoperative studies →

Lead sponsor

University of Puerto Rico is the lead sponsor of 45 studies on the registry; 15 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 110 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Hispanic American patients undergoing primary total knee arthroplasty
  • Older than 21 years of age
  • Classified with an American Society of Anesthesiologist Classification (ASA) of I or II.

Exclusion criteria

Exclusion Criteria:

  • Hypersensitivity to any components of analgesic drugs
  • Impaired renal, cardiac, or hepatic function
  • Baseline serum creatinine level higher than 1.2mg/dL
  • History of gastrointestinal bleeding
  • Neuromuscular deformities
  • Inability to consent
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
81 participants (actual)

Study arms

  • Experimental
    Opioid Sparing Multimodal Regimen

    After surgery, the experimental group will receive a combination of ketorolac 30 mg intravenous (IV) every six hours for patients younger than 65 years old or ketorolac 15mg IV every six hours for those older than 65 years old; and acetaminophen 1 gram by mouth (PO) every six hours up to 72 hours

    Drug: Opioid sparing protocol

  • Experimental
    Opioid Based Multimodal Regimen

    After surgery, the control group will receive a combination of morphine 0.1 mg/kg IV every six hours and oxycodone combined with acetaminophen (2.5 mg / 325 mg) two tabs PO every six hours up to 72 hours

    Drug: Opioid based protocol

Interventions

  • DrugOpioid based protocol

    Use of combination of drug dosage frequency and duration of morphine injection with percocet oral as standard postoperative pain control for up to 72 hours as requested by each patient

    Also known as: morphine injection, percocet oral

  • DrugOpioid sparing protocol

    Use of combination of drug dosage frequency and duration of ketorolac injection with acetaminophen oral as standard postoperative pain control for up to 72 hours as requested by each patient

    Also known as: ketorolac injection, acetaminophen oral

06

What researchers measure

Primary outcomes

  1. Pain scores using numerical rating scale (NRS, 0 to 10)

    The amount of pain intensity reported will be measure throughout the numerical rating scale. Each patient will rate their pain intensity on a scale from 0 to 10, where zero represents "no pain," whereas 10 represents the "most intense pain" (e.g., "the most intense pain imaginable," "the maximum pain intensity as it could be"); during the 12 hours postoperative period

    Time frame: Post-operative 12 hours after surgery

  2. Pain scores using numerical rating scale (NRS, 0 to 10)

    The amount of pain intensity reported will be measure throughout the numerical rating scale. Each patient will rate their pain intensity on a scale from 0 to 10, where zero represents "no pain," whereas 10 represents the "most intense pain" (e.g., "the most intense pain imaginable," "the maximum pain intensity as it could be"); during the 24 hours postoperative period

    Time frame: Post-operative 24 hours after surgery

  3. Pain scores using numerical rating scale (NRS, 0 to 10)

    The amount of pain intensity reported will be measure throughout the numerical rating scale. Each patient will rate their pain intensity on a scale from 0 to 10, where zero represents "no pain," whereas 10 represents the "most intense pain" (e.g., "the most intense pain imaginable," "the maximum pain intensity as it could be"); during the 48 hours postoperative period

    Time frame: Post-operative 48 hours after surgery

Secondary outcomes

  1. Hospital Length of Stay

    The number of days per patient from the time of admission to discharge up to 30 days

    Time frame: up to 30 days

  2. Drug-related adverse events

    nausea, dizziness, vomit, tachycardia, pruritus and headache

    Time frame: From the time of surgery after being discharge (0 to 72 hours after surgery)

07

Study locations

1 site
  • University of Puerto Rico Medical Sciences Campus, Ortopaedic Surgery Department
    San Juan, 00936, Puerto Rico
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 26, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05393414
Lead sponsor
University of Puerto Rico
Responsible party
Sponsor
First posted
May 26, 2022
Start date
Nov 25, 2019
Primary completion
Mar 12, 2020
Completion
Mar 12, 2020
Last update
May 26, 2022

Study contacts

Antonio Otero-Lopez, MD
principal investigator · Orthopaedic Surgery Section, University of Puerto Rico Medical Sciences Campus San Juan, Puerto Rico

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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