Study of Post-Operative Pain Relief Using Toradol and Opioids After Prophylactic Femur Nailing in Adults

What this Trial Is About

The opioid crisis has become a significant national epidemic with rising death rates each year. Orthopedic surgeons often prescribe narcotics instead of NSAIDs for post-operative pain due to concerns about delayed healing and nonunion. However, in orthopedic oncology, some patients receive prophylactic intramedullary femoral nails without existing fractures, allowing for the potential use of NSAIDs after surgery. This study aims to evaluate the effects of adding post-operative toradol, an NSAID, to opioids compared to using opioids alone for pain control in these patients. Participants are randomly assigned to one of two groups. In the experimental group, patients younger than 65 receive up to 120 mgday of intravenous ketorolac toradol in divided doses every 6 hours during the first 24 hours after surgery those 65 or older or with advanced kidney impairment receive a lower dose. All patients may also receive acetaminophen, oxycodone-acetaminophen, and morphine as needed while hospitalized, and hydrocodone-acetaminophen or oxycodone at discharge depending on liver function. The control group receives the same pain medications but a placebo saline injection instead of toradol. No nerve blocks are used. During the study, researchers track opioid use measured as milligram morphine equivalents over the first 14 days after surgery. They also assess pain intensity and functional outcomes up to six weeks post-operation using patient-reported scales like PROMIS Pain Intensity, SANE, and Numerical Rating Scale. Safety monitoring includes observing for medication tolerability and adverse effects. The study is sponsored by St. Louis University and continues until March 2027.

Post-Op Pain Control for Prophylactic Intramedullary Nailing.