Overview
The purpose of this study is to learn about the effectiveness of different pain control options after hand and wrist surgery, specifically Ketorolac, Tylenol, and a regional nerve block. Ketorolac (Toradol) is a nonsteroidal anti-inflammatory drug (NSAID) that is similar to ibuprofen (Motrin or Advil). Tylenol (acetaminophen) is a commonly used over the counter drug. A nerve block is pain medication that is applied directly to the nerves around the surgical site before the surgery and keeps working to reduce pain in the area for several hours after the surgery. All of these medicines and procedures are approved by the Food and Drug Administration (FDA) for patient care. This study aims to understand if using these medicines in combination helps patients having hand and wrist surgery avoid the need for opioid pain medications.
Description
Participants will be enrolled in two sequential groups:
- The first group will be consented for a post-operative pain control regimen consisting of an intraoperative regional nerve block and 3 days of round-the-clock oral ketorolac, plus prescription strength acetaminophen as needed. These analgesic elements are standard of care for patients undergoing the procedures of interest, as an alternative to opioid use, though subjects of this study will be asked to use them as first-line therapy and receive other medications only for breakthrough pain.
- The second group will be consented for a post-operative pain control regimen consisting of a standard care regimen of intraoperative regional nerve block and 3 days of round-the-clock opioids.
Patients in both groups will be asked to complete surveys in which they rate their pain score and describe what medications they have taken for pain.
Eligibility
Inclusion Criteria:
- Age 18 years or older
- Undergoing upper extremity surgery performed by a hand and upper extremity orthopaedic surgeon at the University of Chicago.
- Undergoing procedure with regional nerve block
Exclusion Criteria:
- Age less than 18 years
- Concomitant chronic opioid use
- Postoperative opioid use (surgery through POD 14) for condition other than repaired fracture
- Medical contraindication to ketorolac use, including pregnancy
- Undergoing multiple concurrent surgical procedures
- Unable to communicate numerical pain score
