Rotator Cuff Pathway
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 10/26/2018 |
| Start Date: | September 7, 2018 |
| End Date: | September 7, 2022 |
The Association Between a Comprehensive Multimodal Pathway And Pain 0-48 Hours After Arthroscopic Rotator Cuff Repair: A Before-and After Study
Rotator cuff surgery is mostly performed on an outpatient basis, and many patients still
experience moderate to severe pain after surgery, despite the use of regional anesthesia and
opioids. The specific aim is to determine whether a comprehensive pathway that includes a
well-defined regional technique and multimodal analgesia will reduce the worst pain with
movement 0-48 hours after block placement compared to the current standard practice. This is
a 'before and after' study. We plan to have 70 patients studied prior to initiation of a
pathway, and 70 patients studied after initiation of a pathway. Both groups will receive
identical postoperative follow-up.
experience moderate to severe pain after surgery, despite the use of regional anesthesia and
opioids. The specific aim is to determine whether a comprehensive pathway that includes a
well-defined regional technique and multimodal analgesia will reduce the worst pain with
movement 0-48 hours after block placement compared to the current standard practice. This is
a 'before and after' study. We plan to have 70 patients studied prior to initiation of a
pathway, and 70 patients studied after initiation of a pathway. Both groups will receive
identical postoperative follow-up.
Inclusion Criteria:
- Ambulatory rotator cuff patients with participating surgeons.
Includes the following concomitant procedures:
- Arthroscopic SLAP (Superior Labrum Anterior and Posterior) repair
- Arthroscopic Stabilization
- Arthroscopic AC (Acromioclavicular) resection
- Arthroscopic SAD (Sub-Acromial Decompression)
- Arthroscopic or mini open biceps tenodesis
- Age 18-80
Exclusion Criteria:
- chronic pain history (defined as use of opioids > 3 months or current gabapentinoids
for pain)
- open surgery (but sub pectoralis mini open biceps tenodesis is not excluded)
- revision surgery
- kidney disease (GFR < 60 ml/min/1.73 m2 for 3 months or more)
- liver disease (transaminitis, cirrhosis, hepatitis, hypoalbuminemia, coagulopathy)
- planned avoidance of regional anesthesia
- any contraindication to or patient refusal of any component in the pathway
- Non-English speakers
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