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This proposal aims to measure the quality of recovery and quality of pain management after shoulder surgery before and after implementation of a multimodal pain protocol.
Pain management after shoulder surgery remains to be a major challenge. Reliance on a single agent (most commonly opioids) results in increased incidence of side effects. Multimodal pain management refers to the use of multiple drugs that target different components of pain pathway.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| pre-MP3 | before implementation of the multimodal analgesia protocol | ||
| post-MP3 | after implementation of the multimodal analgesia protocol |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| multimodal perioperative pain protocol (MP3) | Combination Product | administration of gabapentionoid, acetaminophen, non steroidal anti-inflammatory drugs around the clock in addition to the peripheral nerve block offered before surgery |
| Measure | Description | Time Frame |
|---|---|---|
| QOR-9 | quality of recovery score using the QOR-9 instrument: it is a 9 item questionnaire with each question scoring from 0,1,2 with a total highest possible score of 18 | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| quality of pain management | quality of pain management was measured using the revised american pain society patient oriented outcome questionnaire (APS-POQ-R). The questionnaire measures quality of pain management in 5 domains: 1- pain intensity 2- pain interference with activity and sleep 3- emotional side effects of uncontrolled pain ( affective scale). 4- patient perception of their pain management 5-side effects of pain treatment some questions answers are on a scale from 0-10. Ten is the maximum score and zero is the minimum score. other questions are listed as percentage with increments of 10% at a time (0%,10%, 20%, 30%..etc). each item/question is reported individually |
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Inclusion Criteria:
Exclusion Criteria:
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patients scheduled for shoulder arthroscopy
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30113685 | Derived | Elkassabany NM, Wang A, Ochroch J, Mattera M, Liu J, Kuntz A. Improved Quality of Recovery from Ambulatory Shoulder Surgery After Implementation of a Multimodal Perioperative Pain Management Protocol. Pain Med. 2019 May 1;20(5):1012-1019. doi: 10.1093/pm/pny152. |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| 24 and 48 hours |
| amount of opioids | amount of opioids used converted to mg equivalent of oxycodone | 24, 48 and 72 hours after surgery |
| QOR-9 | quality of recovery score using the QOR-9 instrument: it is a 9 item questionnaire with each question scoring from 0,1,2 with a total highest possible score of 18 | at 48 hours and 72 hours |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |