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Not yet recruitingNCT06917118WALANTUpdated Apr 8, 2025

Multimodal Pain Management After Wide Awake Local Anesthesia No Tourniquet Orthopedic Hand Surgery: A Randomized Control Trial

An interventional study of Oxycodone 5mg taken first and Acetaminophen in Pain Management, sponsored by University of Puerto Rico. Not yet recruiting at 1 site in Puerto Rico. Open to participants aged 21 Years to 70 Years. Per ClinicalTrials.gov, last updated 2025-04-08.

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

From the registry’s dates

  • Primary completion was expected by Nov 2025, 11 months ago, but the record still lists the study as not yet recruiting.
Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
21 Years to 70 Years
Sex
All
01

Study summary

The main objective of the study is to measure the efficacy of a multimodal postoperative pain regimen consisting of oral acetaminophen and naproxen compared to a traditional opioid-only pain regimen following elective wide awake local anesthesia no tourniquet (WALANT) hand surgery in a Hispanic population. The study is a randomized control trial comparing the clinical outcomes of patients undergoing elective WALANT hand surgery performed by a board-certified, fellowship-trained orthopedic hand surgeon (Dr. Christian A. Foy).

The study groups are:

  • Control group: standard pain control with opioids
  • Experimental group: multimodal non-opioid pain control

Study Outcomes are:

  • VAS pain scores (7 days),
  • Total opioid usage
  • Patient satisfaction
  • Adverse events

We hypothesize that patients receiving multimodal pain regimens will report lower opioid use, lower pain scores, and greater satisfaction than patients receiving traditional opioid-only pain management.

Read the detailed description

The main objective of the study is to measure the efficacy of a multimodal postoperative pain regimen consisting of oral acetaminophen and naproxen compared to a traditional opioid-only pain regimen following elective wide awake local anesthesia no tourniquet (WALANT) hand surgery in a Hispanic population. The study is a single-blind, single-center randomized control trial comparing the clinical outcomes of patients undergoing elective WALANT hand surgery performed by a board-certified, fellowship-trained orthopedic hand surgeon (Dr. Christian A. Foy). Patients will be consecutively recruited at the center and randomized in a 1:1 ratio into the control and experimental groups. The control group will receive the standard of care for postoperative pain: 10 pills of 5mg oxycodone Q4hrs as needed. The experimental group will receive 30 pills of 500mg acetaminophen Q4hrs and 30 pills of 500mg naproxen Q4hrs until pain resolves or treatment is completed. The experimental group will also receive 5 tablets of 5mg oxycodone to take Q4hrs as needed for breakthrough pain. Postoperatively, daily pain Visual Analog Scale (VAS) scores, total opioid usage, patient satisfaction, and adverse events will be recorded. We hypothesize that patients receiving multimodal pain regimens will report lower opioid use, lower pain scores, and greater satisfaction than patients receiving traditional opioid-only pain management.

02

Conditions studied

  • Pain Management

Keywords

  • WALANT
  • Multimodal analgesia
  • Nonopioid pain management
  • VAS pain scores
03

In context

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.

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Who can participate

Ages eligible
21 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients 21-70 years of age undergoing outpatient hand surgery
  • Patients undergoing surgery with WALANT technique
  • Patients who provide written informed consent

Exclusion criteria

Exclusion Criteria:

  • Patients aged 20 and younger, or 71 and older
  • Patient with chronic pain requiring opioid use
  • Pregnant patients
  • Patients who do not self-identify as Hispanic
  • Patients with known allergy to the medication
  • Patients with contraindications for the prescribed medications
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Care provider, Investigator, Outcomes assessor)
Enrollment
100 participants (estimated)

Study arms

  • Active comparator
    Standard Postoperative opioid analgesia

    10 pills of 5mg oxycodone Q4hrs as needed

    Drug: Oxycodone 5mg taken first

  • Experimental
    Postoperative Opioid-sparing Multimodal analgesia

    30 pills of 500mg acetaminophen Q4hrs and 30 pills of 500mg naproxen Q4hrs. Will also receive 5 tablets of 5mg oxycodone to take Q4hrs as needed for breakthrough pain

    Drug: Acetaminophen · Drug: Naproxen Tablets, 500 mg · Drug: OxyCODONE 5 mg Oral Tablet

Interventions

  • DrugOxycodone 5mg taken first

    10 pills of 5mg oxycodone Q4hrs as needed

  • DrugAcetaminophen

    30 pills of 500mg acetaminophen Q4hrs

  • DrugNaproxen Tablets, 500 mg

    30 pills of 500mg naproxen Q4hrs

  • DrugOxyCODONE 5 mg Oral Tablet

    Only used for breakthrough pain

06

What researchers measure

Primary outcomes

  1. VAS Pain Scores

    VAS pain scores will be assessed using a patient- completed VAS pain questionnaire until 7 days post-op. Patients will take the questionnaire home and report pain scores in the morning and in the afternoon every day for a week.

    Time frame: From enrollment to the end of treatment at 7 days

  2. Patient Satisfaction

    Patient satisfaction will be assessed using the Patient Satisfaction Questionnaire Short Form (PSQ-18)

    Time frame: From enrollment to the end of treatment at 7 days

  3. Total Opioid Usage

    Will be reported in as morphine milligram equivalents (MMEs)

    Time frame: From enrollment to the end of treatment at 7 days

Secondary outcomes

  1. Breakthrough Pain

    Breakthrough pain will be reported as a binary outcome (Y/N)

    Time frame: From enrollment to the end of treatment at 7 days

  2. Length of Treatment

    Patients will be asked to report the number of days in which they used the provided pain control treatment

    Time frame: From enrollment to the end of treatment at 7 days

  3. Indication for WALANT surgery

    We will report the indication for treatment for each patient to include in the final analysis

    Time frame: From enrollment to the end of treatment at 7 days

07

Study locations

1 site
  • Oncological Hospital
    San Juan, 00935, Puerto Rico
08

References and documents

Publications

  • Abdullah S, Ahmad AA, Lalonde D. Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy. Plast Reconstr Surg Glob Open. 2020 Aug 11;8(8):e3023. doi: 10.1097/GOX.0000000000003023. eCollection 2020 Aug. PubMed 32983779 ↗
  • Burn MB, Shapiro LM, Eppler SL, Behal R, Kamal RN. Clinical Care Redesign to Improve Value for Trigger Finger Release: A Before-and-After Quality Improvement Study. Hand (N Y). 2021 Sep;16(5):624-631. doi: 10.1177/1558944719884661. Epub 2019 Nov 5. PubMed 31690136 ↗
  • Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie Project clinical phase. J Hand Surg Am. 2005 Sep;30(5):1061-7. doi: 10.1016/j.jhsa.2005.05.006. PubMed 16182068 ↗
  • Chowdhry S, Seidenstricker L, Cooney DS, Hazani R, Wilhelmi BJ. Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010 Dec;126(6):2031-2034. doi: 10.1097/PRS.0b013e3181f44486. PubMed 20697319 ↗
  • Sawhney A, Thacoor A, Nagra R, Geoghegan L, Akhavani M. Wide Awake Local Anesthetic No Tourniquet in Hand and Wrist Surgery: Current Concepts, Indications, and Considerations. Plast Reconstr Surg Glob Open. 2024 Jan 22;12(1):e5526. doi: 10.1097/GOX.0000000000005526. eCollection 2024 Jan. PubMed 38260757 ↗
  • Deutsch CJ, Jones K, Dassayanake S, Milroy C. Concern about ischaemia drives a persistent and generation-spanning aversion to adrenaline in digital anaesthesia. JPRAS Open. 2021 Jan 26;28:61-63. doi: 10.1016/j.jpra.2021.01.006. eCollection 2021 Jun. No abstract available. PubMed 33732855 ↗
  • Fillingham YA, Hannon CP, Erens GA; AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup; Hamilton WG, Della Valle CJ. Acetaminophen in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty. 2020 Oct;35(10):2697-2699. doi: 10.1016/j.arth.2020.05.030. Epub 2020 May 26. No abstract available. PubMed 32571591 ↗
  • Padilla JA, Gabor JA, Schwarzkopf R, Davidovitch RI. A Novel Opioid-Sparing Pain Management Protocol Following Total Hip Arthroplasty: Effects on Opioid Consumption, Pain Severity, and Patient-Reported Outcomes. J Arthroplasty. 2019 Nov;34(11):2669-2675. doi: 10.1016/j.arth.2019.06.038. Epub 2019 Jun 26. PubMed 31311667 ↗
  • Gimbel JS, Brugger A, Zhao W, Verburg KM, Geis GS. Efficacy and tolerability of celecoxib versus hydrocodone/acetaminophen in the treatment of pain after ambulatory orthopedic surgery in adults. Clin Ther. 2001 Feb;23(2):228-41. doi: 10.1016/s0149-2918(01)80005-9. PubMed 11293556 ↗
  • Thompson KA, Klein D, Alaia MJ, Strauss EJ, Jazrawi LM, Campbell KA. Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study. Arthrosc Sports Med Rehabil. 2020 Dec 27;3(1):e15-e22. doi: 10.1016/j.asmr.2020.08.003. eCollection 2021 Feb. PubMed 33615243 ↗
  • Hess-Arcelay H, Claudio-Marcano A, Torres-Lugo NJ, Deliz-Jimenez D, Acosta-Julbe J, Hernandez G, Deliz-Jimenez D, Monge G, Ramirez N, Lojo-Sojo L. Opioid-Sparing Nonsteroid Anti-inflammatory Drugs Protocol in Patients Undergoing Intramedullary Nailing of Tibial Shaft Fractures: A Randomized Control Trial. J Am Acad Orthop Surg. 2024 Jun 15;32(12):e596-e604. doi: 10.5435/JAAOS-D-23-01014. Epub 2024 Apr 4. PubMed 38579315 ↗
  • American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012 Feb;116(2):248-73. doi: 10.1097/ALN.0b013e31823c1030. No abstract available. PubMed 22227789 ↗
  • Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg. 1997 Oct;85(4):808-16. doi: 10.1097/00000539-199710000-00017. PubMed 9322460 ↗
  • Pasero C, McCaffery M. Orthopaedic postoperative pain management. J Perianesth Nurs. 2007 Jun;22(3):160-72; quiz 172-3. doi: 10.1016/j.jopan.2007.02.004. PubMed 17543801 ↗
  • Trasolini NA, McKnight BM, Dorr LD. The Opioid Crisis and the Orthopedic Surgeon. J Arthroplasty. 2018 Nov;33(11):3379-3382.e1. doi: 10.1016/j.arth.2018.07.002. Epub 2018 Jul 11. PubMed 30075877 ↗
  • Harris JD. Management of expected and unexpected opioid-related side effects. Clin J Pain. 2008 May;24 Suppl 10:S8-S13. doi: 10.1097/AJP.0b013e31816b58eb. PubMed 18418226 ↗
  • Huynh MNQ, Yuan M, Gallo L, Olaiya OR, Barkho J, McRae M. Opioid Consumption After Upper Extremity Surgery: A Systematic Review. Hand (N Y). 2024 Sep;19(6):1002-1011. doi: 10.1177/15589447231160211. Epub 2023 Mar 23. PubMed 36960481 ↗
  • Feinberg AE, Chesney TR, Srikandarajah S, Acuna SA, McLeod RS; Best Practice in Surgery Group. Opioid Use After Discharge in Postoperative Patients: A Systematic Review. Ann Surg. 2018 Jun;267(6):1056-1062. doi: 10.1097/SLA.0000000000002591. PubMed 29215370 ↗
  • Fader L, Whitaker J, Lopez M, Vivace B, Parra M, Carlson J, Zamora R. Tibia fractures and NSAIDs. Does it make a difference? A multicenter retrospective study. Injury. 2018 Dec;49(12):2290-2294. doi: 10.1016/j.injury.2018.09.024. Epub 2018 Sep 18. PubMed 30270011 ↗
  • Rodgers J, Cunningham K, Fitzgerald K, Finnerty E. Opioid consumption following outpatient upper extremity surgery. J Hand Surg Am. 2012 Apr;37(4):645-50. doi: 10.1016/j.jhsa.2012.01.035. Epub 2012 Mar 10. PubMed 22410178 ↗

Individual participant data

Plan to share: No — Individual Participant Data (IPD) will only be used internally by the study PI and primary investigators.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06917118
Lead sponsor
University of Puerto Rico
Responsible party
Daniel Deliz (Dr. Christian A. Foy, University of Puerto Rico) — Principal investigator
First posted
Apr 8, 2025
Start date
May 1, 2025 (estimated)
Primary completion
Nov 1, 2025 (estimated)
Completion
Dec 1, 2025 (estimated)
Last update
Apr 8, 2025

Study contacts

Jose I Acosta Julbe, MD
Contact
jose.acosta14@upr.edu
+1 7873794119
Daniel E. Deliz Jiménez, BSc
Contact
daniel.deliz@upr.edu
+1 7872332369
Christian A. Foy, MD
principal investigator · University of Puerto Rico Medical Sciences Campus

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.

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