Intrathecal Opioids for Pain Control After Colorectal Resection

Overview

About this study

Pain control is a key for successful postoperative recovery after colorectal (i.e., involving large bowel or rectum) surgery. Spinal analgesia has been shown to be safe and efficacious and commonly used in clinical practice. It involves administering pain medicine through a small needle in the lower portion of a patient's back. The pain medications most commonly used for spinal analgesia are morphine and hydromorphone. Despite their frequent use, the dose which achieves best pain control while reducing unwanted adverse effects has not been determined. We are attempting to determine the optimal dose of spinal morphine and hydromorphone in patients undergoing minimally-invasive (i.e., surgery performed through small entry sites and using cameras) colorectal surgery.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

Adult patients with an American Society of Anesthesiologists (ASA) physiological status I-III.
Undergoing colorectal minimally invasive surgery (MIS).
Age between 18 and 75 years of age.
Body mass index (BMI) between 18.5 and 40.
Ability to understand and read English.

Exclusion Criteria:

Not able or unwilling to sign consent.
Patients undergoing ileostomy closure.
Patients undergoing ambulatory surgery or anticipated to be discharged sooner than 24 hours after surgery
Patients with chronic pain, requiring daily opioid use at the time of surgery.
Patient intolerant or allergic to opioids, NSAIDs, or acetaminophen.
Patients requiring emergent surgery.
Any contraindication to neuraxial anesthesia (coagulopathy, localized infection at the site of injection, pre-existing spinal pathology, or peripheral neuropathy).
Any patients currently receiving any anticoagulation medication other than aspirin and who have not discontinued the medication per American Society of Regional Anesthesia anticoagulation guidelines22, and/or an abnormal INR.
Patients with hepatic or renal insufficiency in as much as the patient is not a candidate for acetaminophen or NSAIDs, respectively.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location	Status
Rochester, Minn. Mayo Clinic principal investigator Adam Amundson, M.D.	Closed for enrollment

Mayo Clinic Location

Status

Rochester, Minn.

Mayo Clinic principal investigator

Adam Amundson, M.D.

Closed for enrollment

More information

Publications

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