Trial Outcomes & Findings for Post-op Acetaminophen vs NSAID Use on Lumbar Spinal Fusion Outcomes (NCT NCT02700451)
NCT ID: NCT02700451
Last Updated: 2023-07-10
Results Overview
Measure the impact of treatment on total opioid use during the hospital stay
COMPLETED
NA
178 participants
Hospital stay (2-4 days)
2023-07-10
Participant Flow
Assessed for eligibility (n= 1,372) Excluded (n= 1,194) * Not meeting inclusion criteria (n= 1,137) * Declined to participate (n= 132) * Other reasons (n= 103)
Participant milestones
| Measure |
IV Ketorolac
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Overall Study
STARTED
|
60
|
60
|
58
|
|
Overall Study
COMPLETED
|
44
|
43
|
41
|
|
Overall Study
NOT COMPLETED
|
16
|
17
|
17
|
Reasons for withdrawal
| Measure |
IV Ketorolac
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Overall Study
Protocol Violation
|
2
|
2
|
3
|
|
Overall Study
Discontinued intervention
|
14
|
15
|
14
|
Baseline Characteristics
Post-op Acetaminophen vs NSAID Use on Lumbar Spinal Fusion Outcomes
Baseline characteristics by cohort
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Total
n=128 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Categorical
<=18 years
|
0 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
0 Participants
n=7 Participants
|
|
Age, Categorical
Between 18 and 65 years
|
31 Participants
n=99 Participants
|
32 Participants
n=107 Participants
|
31 Participants
n=206 Participants
|
94 Participants
n=7 Participants
|
|
Age, Categorical
>=65 years
|
13 Participants
n=99 Participants
|
11 Participants
n=107 Participants
|
10 Participants
n=206 Participants
|
34 Participants
n=7 Participants
|
|
Age, Continuous
|
58.5 years
STANDARD_DEVIATION 11.2 • n=99 Participants
|
56.3 years
STANDARD_DEVIATION 11.1 • n=107 Participants
|
56.1 years
STANDARD_DEVIATION 13.2 • n=206 Participants
|
57.0 years
STANDARD_DEVIATION 11.8 • n=7 Participants
|
|
Sex: Female, Male
Female
|
18 Participants
n=99 Participants
|
17 Participants
n=107 Participants
|
20 Participants
n=206 Participants
|
55 Participants
n=7 Participants
|
|
Sex: Female, Male
Male
|
26 Participants
n=99 Participants
|
26 Participants
n=107 Participants
|
21 Participants
n=206 Participants
|
73 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
0 Participants
n=99 Participants
|
2 Participants
n=107 Participants
|
1 Participants
n=206 Participants
|
3 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
44 Participants
n=99 Participants
|
40 Participants
n=107 Participants
|
39 Participants
n=206 Participants
|
123 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=99 Participants
|
1 Participants
n=107 Participants
|
1 Participants
n=206 Participants
|
2 Participants
n=7 Participants
|
|
Region of Enrollment
United States
|
44 participants
n=99 Participants
|
43 participants
n=107 Participants
|
41 participants
n=206 Participants
|
128 participants
n=7 Participants
|
PRIMARY outcome
Timeframe: Hospital stay (2-4 days)Measure the impact of treatment on total opioid use during the hospital stay
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Perioperative Opioid Use
OME total in the first 72H
|
86.25 oral morphine equivalents (OME) (mmg)
Interval 39.6 to 245.55
|
306.6 oral morphine equivalents (OME) (mmg)
Interval 161.0 to 423.0
|
192.4 oral morphine equivalents (OME) (mmg)
Interval 91.55 to 372.85
|
|
Perioperative Opioid Use
OME total to discharge
|
88.95 oral morphine equivalents (OME) (mmg)
Interval 46.2 to 284.03
|
324 oral morphine equivalents (OME) (mmg)
Interval 169.0 to 471.0
|
237.9 oral morphine equivalents (OME) (mmg)
Interval 91.55 to 467.05
|
SECONDARY outcome
Timeframe: 4-6 weeksPopulation: Patient treated Per-Protocol with completed follow-up
Track opioid use after discharge for the first 4-6 weeks
Outcome measures
| Measure |
IV Ketorolac
n=43 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=39 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=36 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Opioid Use at 4-6 Weeks
No opioid use
|
34 Participants
|
33 Participants
|
22 Participants
|
|
Opioid Use at 4-6 Weeks
Opioid use
|
9 Participants
|
6 Participants
|
14 Participants
|
SECONDARY outcome
Timeframe: 3 monthsPopulation: Patient treated Per-Protocol with completed follow-up
Track opioid use after discharge for the first 3 months; assess for continued opioid use
Outcome measures
| Measure |
IV Ketorolac
n=37 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=27 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=31 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Opioid Use at 3 Months
No opioid use
|
32 Participants
|
25 Participants
|
26 Participants
|
|
Opioid Use at 3 Months
Opioid use
|
5 Participants
|
2 Participants
|
5 Participants
|
SECONDARY outcome
Timeframe: 1 yearPopulation: Patient treated Per-Protocol with completed follow-up
Track opioid use after discharge for the first 1 year; assess for continued opioid use
Outcome measures
| Measure |
IV Ketorolac
n=33 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=31 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=22 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Opioid Use at 1 Year
No opioid use
|
32 Participants
|
31 Participants
|
21 Participants
|
|
Opioid Use at 1 Year
Opioid use
|
1 Participants
|
0 Participants
|
1 Participants
|
SECONDARY outcome
Timeframe: 2 yearsPopulation: Patient treated Per-Protocol with completed follow-up
Track total opioid use after discharge for the first 2 years; assess for continued opioid use
Outcome measures
| Measure |
IV Ketorolac
n=27 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=27 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=25 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Opioid Use at 2 Years
No opioid use
|
26 Participants
|
26 Participants
|
22 Participants
|
|
Opioid Use at 2 Years
Opioid use
|
1 Participants
|
1 Participants
|
3 Participants
|
SECONDARY outcome
Timeframe: 1 days and 3 daysPopulation: Analysis performed on patient with data completed.
Validated pain scale; will be completed by patient Minimum Score: 0 \& Maximum score 100 A lower score is representative of a low pain level
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Numerical Pain Rating Scale
POD1 - Best pain level
|
23 units on a scale
Interval 13.0 to 40.0
|
24.5 units on a scale
Interval 13.0 to 34.5
|
21 units on a scale
Interval 12.5 to 51.0
|
|
Numerical Pain Rating Scale
POD3 - Current pain level
|
66 units on a scale
Interval 26.0 to 76.8
|
47 units on a scale
Interval 25.5 to 74.0
|
52 units on a scale
Interval 25.0 to 65.0
|
|
Numerical Pain Rating Scale
PDO3 - Best pain level
|
23 units on a scale
Interval 12.0 to 36.0
|
25 units on a scale
Interval 12.5 to 50.0
|
39 units on a scale
Interval 18.8 to 51.0
|
|
Numerical Pain Rating Scale
POD3 - Worst pain level
|
84 units on a scale
Interval 69.0 to 88.0
|
83 units on a scale
Interval 51.5 to 93.5
|
72.5 units on a scale
Interval 62.8 to 85.0
|
|
Numerical Pain Rating Scale
POD1 - Current pain level
|
39 units on a scale
Interval 22.0 to 58.0
|
46 units on a scale
Interval 29.3 to 72.0
|
42 units on a scale
Interval 25.5 to 67.0
|
|
Numerical Pain Rating Scale
POD1 - Worst pain level
|
62 units on a scale
Interval 44.0 to 73.0
|
89.5 units on a scale
Interval 66.3 to 97.8
|
74 units on a scale
Interval 54.0 to 86.5
|
SECONDARY outcome
Timeframe: 1 day and 3 daysPopulation: Patient treated Per-Protocol with completed follow-up
The Brief Pain Inventory (BPI) is a self-administered questionnaire for chronic pain conditions. The BPI gives two main scores: a pain severity score and a pain interference score. The pain severity score is calculated from the four items about pain intensity. Each item is rated from 0, no pain, to 10, pain as bad as you can imagine, and contributes with the same weight to the final score, ranging from 0 to 40. The pain interference score corresponds to the item on pain interference. The seven sub-items are rated from 0, does not interfere, to 10, completely interferes, and contributes with the same weight to the final score, ranging from 0 to 70. The first item, pain drawing diagrams (painful and most painful areas) and the items on pain relief treatment or medication (list of the treatments and amount of relief) do not contribute to the scoring.
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Brief Pain Inventory
POD1 - Pain has interfered with General Activity
|
6.5 score on a scale
Interval 3.25 to 10.0
|
9 score on a scale
Interval 6.0 to 10.0
|
9 score on a scale
Interval 6.0 to 10.0
|
|
Brief Pain Inventory
POD1 - Pain has interfered with Sleep
|
3 score on a scale
Interval 1.0 to 6.75
|
5 score on a scale
Interval 1.0 to 8.75
|
6 score on a scale
Interval 2.75 to 8.0
|
|
Brief Pain Inventory
POD1 - Pain has interfered with Enjoyment of life
|
5 score on a scale
Interval 2.0 to 8.75
|
9 score on a scale
Interval 5.0 to 10.0
|
7 score on a scale
Interval 4.0 to 10.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with General Activity
|
8 score on a scale
Interval 3.0 to 10.0
|
7 score on a scale
Interval 5.0 to 10.0
|
8 score on a scale
Interval 7.0 to 10.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with Mood
|
5 score on a scale
Interval 1.0 to 7.0
|
3 score on a scale
Interval 0.0 to 6.75
|
5 score on a scale
Interval 2.0 to 7.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with Walking Ability
|
5 score on a scale
Interval 4.0 to 7.0
|
4.5 score on a scale
Interval 3.0 to 8.0
|
6 score on a scale
Interval 5.0 to 7.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with Normal work
|
9 score on a scale
Interval 8.0 to 10.0
|
10 score on a scale
Interval 5.25 to 10.0
|
8 score on a scale
Interval 6.25 to 10.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with Relation with other
|
2 score on a scale
Interval 0.0 to 7.0
|
2 score on a scale
Interval 0.0 to 5.0
|
4 score on a scale
Interval 0.0 to 6.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with Enjoyment of life
|
7 score on a scale
Interval 4.0 to 9.0
|
6.5 score on a scale
Interval 3.25 to 10.0
|
8 score on a scale
Interval 5.5 to 9.0
|
|
Brief Pain Inventory
POD3 - Pain has interfered with Sleep
|
6 score on a scale
Interval 4.0 to 8.0
|
4 score on a scale
Interval 1.25 to 7.0
|
5 score on a scale
Interval 4.0 to 7.75
|
|
Brief Pain Inventory
POD1 - Pain has interfered with Mood
|
2 score on a scale
Interval 0.0 to 6.0
|
4 score on a scale
Interval 0.0 to 6.0
|
1.5 score on a scale
Interval 0.0 to 6.0
|
|
Brief Pain Inventory
POD1 - Pain has interfered with Walking Ability
|
5 score on a scale
Interval 2.0 to 9.0
|
7 score on a scale
Interval 5.25 to 10.0
|
7 score on a scale
Interval 5.0 to 9.0
|
|
Brief Pain Inventory
POD1 - Pain has interfered with Normal work
|
8 score on a scale
Interval 3.75 to 10.0
|
10 score on a scale
Interval 7.0 to 10.0
|
8 score on a scale
Interval 6.5 to 10.0
|
|
Brief Pain Inventory
POD1 - Pain has interfered with Relation with other
|
0 score on a scale
Interval 0.0 to 3.75
|
2.5 score on a scale
Interval 0.0 to 5.75
|
1.5 score on a scale
Interval 0.0 to 6.0
|
SECONDARY outcome
Timeframe: Hospital Stay (1-4 days)Population: Patient treated Per-Protocol with completed follow-up
Ileus, nausea/vomiting, first bowel movement, first flatus, treated pruritis will be identified and recorded
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Opioid Related Side Effects
POD1 - Nausea? · No
|
28 Participants
|
23 Participants
|
21 Participants
|
|
Opioid Related Side Effects
POD1 - Vomiting? · Yes
|
1 Participants
|
5 Participants
|
5 Participants
|
|
Opioid Related Side Effects
POD1 - Vomiting? · No
|
43 Participants
|
35 Participants
|
32 Participants
|
|
Opioid Related Side Effects
POD1 - Constipation? · Yes
|
19 Participants
|
18 Participants
|
7 Participants
|
|
Opioid Related Side Effects
POD1 - Difficulty passing urine? · No
|
33 Participants
|
27 Participants
|
32 Participants
|
|
Opioid Related Side Effects
POD1 - Difficulty concentrating? · Yes
|
14 Participants
|
18 Participants
|
12 Participants
|
|
Opioid Related Side Effects
POD1 - Difficulty concentrating? · No
|
30 Participants
|
22 Participants
|
24 Participants
|
|
Opioid Related Side Effects
POD1 - Drowsiness/Difficulty Staying Awake? · Yes
|
21 Participants
|
25 Participants
|
21 Participants
|
|
Opioid Related Side Effects
POD1 - Drowsiness/Difficulty Staying Awake? · No
|
23 Participants
|
15 Participants
|
17 Participants
|
|
Opioid Related Side Effects
POD1 - Lightheaded or dizzy? · No
|
20 Participants
|
19 Participants
|
19 Participants
|
|
Opioid Related Side Effects
POD1 - Feeling confused? · Yes
|
4 Participants
|
8 Participants
|
3 Participants
|
|
Opioid Related Side Effects
POD1 - Fatigue? · No
|
27 Participants
|
17 Participants
|
18 Participants
|
|
Opioid Related Side Effects
POD1 - Itchiness? · Yes
|
9 Participants
|
14 Participants
|
13 Participants
|
|
Opioid Related Side Effects
POD1 - Itchiness? · No
|
35 Participants
|
26 Participants
|
25 Participants
|
|
Opioid Related Side Effects
POD1 - Dry mouth? · Yes
|
33 Participants
|
36 Participants
|
29 Participants
|
|
Opioid Related Side Effects
POD1 - Dry mouth? · No
|
11 Participants
|
4 Participants
|
9 Participants
|
|
Opioid Related Side Effects
POD3 - Headache? · No
|
29 Participants
|
25 Participants
|
20 Participants
|
|
Opioid Related Side Effects
POD1 - Nausea? · Yes
|
16 Participants
|
17 Participants
|
17 Participants
|
|
Opioid Related Side Effects
POD1 - Constipation? · No
|
25 Participants
|
22 Participants
|
31 Participants
|
|
Opioid Related Side Effects
POD1 - Difficulty passing urine? · Yes
|
11 Participants
|
13 Participants
|
5 Participants
|
|
Opioid Related Side Effects
POD1 - Lightheaded or dizzy? · Yes
|
24 Participants
|
21 Participants
|
18 Participants
|
|
Opioid Related Side Effects
POD1 - Feeling confused? · No
|
40 Participants
|
32 Participants
|
34 Participants
|
|
Opioid Related Side Effects
POD1 - Fatigue? · Yes
|
17 Participants
|
23 Participants
|
20 Participants
|
|
Opioid Related Side Effects
POD1 - Headache? · Yes
|
5 Participants
|
6 Participants
|
3 Participants
|
|
Opioid Related Side Effects
POD1 - Headache? · No
|
38 Participants
|
34 Participants
|
35 Participants
|
|
Opioid Related Side Effects
POD3 - Nausea? · Yes
|
10 Participants
|
12 Participants
|
5 Participants
|
|
Opioid Related Side Effects
POD3 - Nausea? · No
|
26 Participants
|
24 Participants
|
25 Participants
|
|
Opioid Related Side Effects
POD3 - Vomiting? · Yes
|
2 Participants
|
1 Participants
|
2 Participants
|
|
Opioid Related Side Effects
POD3 - Vomiting? · No
|
34 Participants
|
35 Participants
|
28 Participants
|
|
Opioid Related Side Effects
POD3 - Constipation? · Yes
|
21 Participants
|
22 Participants
|
15 Participants
|
|
Opioid Related Side Effects
POD3 - Constipation? · No
|
15 Participants
|
14 Participants
|
15 Participants
|
|
Opioid Related Side Effects
POD3 - Difficulty passing urine? · Yes
|
5 Participants
|
5 Participants
|
3 Participants
|
|
Opioid Related Side Effects
POD3 - Difficulty passing urine? · No
|
31 Participants
|
31 Participants
|
27 Participants
|
|
Opioid Related Side Effects
POD3 - Difficulty concentrating? · Yes
|
16 Participants
|
19 Participants
|
13 Participants
|
|
Opioid Related Side Effects
POD3 - Difficulty concentrating? · No
|
20 Participants
|
17 Participants
|
17 Participants
|
|
Opioid Related Side Effects
POD3 - Drowsiness/Difficulty Staying Awake? · Yes
|
20 Participants
|
25 Participants
|
18 Participants
|
|
Opioid Related Side Effects
POD3 - Drowsiness/Difficulty Staying Awake? · No
|
15 Participants
|
11 Participants
|
12 Participants
|
|
Opioid Related Side Effects
POD3 - Lightheaded or dizzy? · Yes
|
10 Participants
|
8 Participants
|
8 Participants
|
|
Opioid Related Side Effects
POD3 - Lightheaded or dizzy? · No
|
26 Participants
|
28 Participants
|
22 Participants
|
|
Opioid Related Side Effects
POD3 - Feeling confused? · Yes
|
5 Participants
|
4 Participants
|
2 Participants
|
|
Opioid Related Side Effects
POD3 - Feeling confused? · No
|
31 Participants
|
32 Participants
|
28 Participants
|
|
Opioid Related Side Effects
POD3 - Fatigue? · Yes
|
23 Participants
|
24 Participants
|
18 Participants
|
|
Opioid Related Side Effects
POD3 - Fatigue? · No
|
13 Participants
|
12 Participants
|
12 Participants
|
|
Opioid Related Side Effects
POD3 - Itchiness? · Yes
|
13 Participants
|
13 Participants
|
10 Participants
|
|
Opioid Related Side Effects
POD3 - Itchiness? · No
|
23 Participants
|
23 Participants
|
20 Participants
|
|
Opioid Related Side Effects
POD3 - Dry mouth? · Yes
|
24 Participants
|
19 Participants
|
20 Participants
|
|
Opioid Related Side Effects
POD3 - Dry mouth? · No
|
12 Participants
|
17 Participants
|
10 Participants
|
|
Opioid Related Side Effects
POD3 - Headache? · Yes
|
7 Participants
|
11 Participants
|
10 Participants
|
SECONDARY outcome
Timeframe: Hospital Stay (1-4 days)Population: Patient treated Per-Protocol with completed data
Complications such as: excessive drain output, elevation in creatinine, and the need for transfusions will be identified and recorded
Outcome measures
| Measure |
IV Ketorolac
n=34 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=38 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=31 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Perioperative Complications - Drain Output
Total Drain output 24H
|
270 mL
Interval 135.0 to 400.0
|
235 mL
Interval 150.0 to 348.75
|
240 mL
Interval 160.0 to 390.0
|
|
Perioperative Complications - Drain Output
Total Drain output 48H
|
390 mL
Interval 203.75 to 530.0
|
305 mL
Interval 200.0 to 515.0
|
320 mL
Interval 240.0 to 520.0
|
|
Perioperative Complications - Drain Output
Total Drain output 72H
|
390 mL
Interval 203.75 to 620.0
|
335 mL
Interval 200.0 to 585.0
|
340 mL
Interval 240.0 to 520.0
|
|
Perioperative Complications - Drain Output
Total Drain output at discharge
|
390 mL
Interval 203.75 to 635.0
|
335 mL
Interval 200.0 to 605.0
|
340 mL
Interval 240.0 to 535.0
|
SECONDARY outcome
Timeframe: Hospital Stay (1-4 days)Population: Patient treated Per-Protocol with completed data
Complications such as: excessive drain output, elevation in creatinine, and the need for transfusions will be identified and recorded
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Perioperative Complications - Transfusion Rate
No transfusion
|
40 Participants
|
42 Participants
|
41 Participants
|
|
Perioperative Complications - Transfusion Rate
Transfusion
|
4 Participants
|
1 Participants
|
0 Participants
|
SECONDARY outcome
Timeframe: Hospital Stay (1-4 days)Days needed to be able to walk 50ft with PT
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Days to Walk 50 ft With PT
POD0
|
30 Participants
|
26 Participants
|
24 Participants
|
|
Days to Walk 50 ft With PT
POD1
|
11 Participants
|
12 Participants
|
14 Participants
|
|
Days to Walk 50 ft With PT
POD2 and after
|
3 Participants
|
5 Participants
|
3 Participants
|
SECONDARY outcome
Timeframe: Hospital Stay (1-4 days)Will record date of discharge
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Length of Stay
|
49.5 Hour
Interval 43.25 to 91.25
|
77 Hour
Interval 67.0 to 100.0
|
70 Hour
Interval 47.0 to 91.5
|
SECONDARY outcome
Timeframe: pre-operativePopulation: Patient treated Per-Protocol with completed follow-up
The Veterans RAND 12 Item Health Survey (VR-12) is a brief, generic, multi-use, self-administered health survey comprised of 12 items. The instrument is primarily used to measure health related quality of life, to estimate disease burden and to evaluate disease-specific benchmarks with other populations. The 12 items in the questionnaire correspond to eight principal physical and mental health domains including general health perceptions; physical functioning; role limitations due to physical and emotional problems; bodily pain; energy-fatigue, social functioning and mental health.. The 12 items are summarized into two scores, a "Physical Health Summary Measure {PCS-physical component score}" and a "Mental Health Summary Measure {MCS-mental component score}". Score range is 0 to 100, higher score denotes a better outcome. This score range apply to both PCS and MCS.
Outcome measures
| Measure |
IV Ketorolac
n=43 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=39 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=36 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Veterans Rand - 12
PCS score
|
34.7 score on a scale
Standard Deviation 10.8
|
34.2 score on a scale
Standard Deviation 10.7
|
34.5 score on a scale
Standard Deviation 9.7
|
|
Veterans Rand - 12
MCS Score
|
43.9 score on a scale
Standard Deviation 6.1
|
42.9 score on a scale
Standard Deviation 6.7
|
42.0 score on a scale
Standard Deviation 7.1
|
SECONDARY outcome
Timeframe: pre-operativePopulation: Patient treated Per-Protocol with pre-operative ODI
The Oswestry Disability Index (ODI) is the most commonly used outcome-measure questionnaire for low back pain in a hospital setting. It is a self-administered questionnaire divided into ten sections designed to assess limitations of various activities of daily living. Each section is scored on a 0-5 scale, 5 representing the greatest disability. The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage. Thus, for every question not answered, the denominator is reduced by 5. If a patient marks more than one statement in a question, the highest scoring statement is recorded as a true indication of disability.
Outcome measures
| Measure |
IV Ketorolac
n=44 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=41 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=38 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Oswestry Disability Index
|
36.3 percentage
Standard Deviation 14.3
|
35.4 percentage
Standard Deviation 11.1
|
40.6 percentage
Standard Deviation 15.9
|
SECONDARY outcome
Timeframe: 3 month follow upPopulation: Patient treated Per-Protocol with completed follow-up
The Veterans RAND 12 Item Health Survey (VR-12) is a brief, generic, multi-use, self-administered health survey comprised of 12 items. The instrument is primarily used to measure health related quality of life, to estimate disease burden and to evaluate disease-specific benchmarks with other populations. The 12 items in the questionnaire correspond to eight principal physical and mental health domains including general health perceptions; physical functioning; role limitations due to physical and emotional problems; bodily pain; energy-fatigue, social functioning and mental health.. The 12 items are summarized into two scores, a "Physical Health Summary Measure {PCS-physical component score}" and a "Mental Health Summary Measure {MCS-mental component score}". Score range is 0 to 100, higher score denotes a better outcome. This score range apply to both PCS and MCS.
Outcome measures
| Measure |
IV Ketorolac
n=31 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=27 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=30 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Veterans Rand - 12
MCS score
|
45.0 score on a scale
Standard Deviation 5.3
|
44.3 score on a scale
Standard Deviation 6.1
|
45.3 score on a scale
Standard Deviation 4.5
|
|
Veterans Rand - 12
PCS score
|
43.1 score on a scale
Standard Deviation 11.8
|
48.7 score on a scale
Standard Deviation 8.8
|
42.3 score on a scale
Standard Deviation 9.9
|
SECONDARY outcome
Timeframe: 3 month follow upPopulation: patient treated Per-Protocol with completed follow-up
The Oswestry Disability Index (ODI) is the most commonly used outcome-measure questionnaire for low back pain in a hospital setting. It is a self-administered questionnaire divided into ten sections designed to assess limitations of various activities of daily living. Each section is scored on a 0-5 scale, 5 representing the greatest disability. The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage. Thus, for every question not answered, the denominator is reduced by 5. If a patient marks more than one statement in a question, the highest scoring statement is recorded as a true indication of disability.
Outcome measures
| Measure |
IV Ketorolac
n=38 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=34 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=34 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Oswestry Disability Index
|
22.8 percentage
Standard Deviation 15.7
|
18.8 percentage
Standard Deviation 12.9
|
25.0 percentage
Standard Deviation 13.6
|
SECONDARY outcome
Timeframe: 3 month follow upPopulation: Patient treated Per-Protocol with completed follow-up
Record return to work
Outcome measures
| Measure |
IV Ketorolac
n=35 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=30 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=33 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Return to Work
Does not Apply
|
9 Participants
|
7 Participants
|
7 Participants
|
|
Return to Work
Complete disability
|
3 Participants
|
5 Participants
|
1 Participants
|
|
Return to Work
Lighter job
|
3 Participants
|
3 Participants
|
0 Participants
|
|
Return to Work
Original job. part time
|
4 Participants
|
3 Participants
|
3 Participants
|
|
Return to Work
Original job, full time
|
15 Participants
|
12 Participants
|
20 Participants
|
|
Return to Work
Early retirement
|
1 Participants
|
0 Participants
|
2 Participants
|
SECONDARY outcome
Timeframe: 1 year follow upPopulation: Patient treated Per-Protocol with completed follow-up
The Veterans RAND 12 Item Health Survey (VR-12) is a brief, generic, multi-use, self-administered health survey comprised of 12 items. The instrument is primarily used to measure health related quality of life, to estimate disease burden and to evaluate disease-specific benchmarks with other populations. The 12 items in the questionnaire correspond to eight principal physical and mental health domains including general health perceptions; physical functioning; role limitations due to physical and emotional problems; bodily pain; energy-fatigue, social functioning and mental health.. The 12 items are summarized into two scores, a "Physical Health Summary Measure {PCS-physical component score}" and a "Mental Health Summary Measure {MCS-mental component score}". Score range is 0 to 100, higher score denotes a better outcome. This score range apply to both PCS and MCS.
Outcome measures
| Measure |
IV Ketorolac
n=30 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=28 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=24 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Veterans Rand - 12
MCS score
|
42.8 score on a scale
Standard Deviation 5.7
|
45.0 score on a scale
Standard Deviation 6.7
|
45.3 score on a scale
Standard Deviation 4.4
|
|
Veterans Rand - 12
PCS score
|
48.1 score on a scale
Standard Deviation 11.6
|
47.6 score on a scale
Standard Deviation 11.9
|
48.4 score on a scale
Standard Deviation 11.1
|
SECONDARY outcome
Timeframe: 1 year follow upPopulation: Patient treated Per-Protocol with completed follow-up
The Oswestry Disability Index (ODI) is the most commonly used outcome-measure questionnaire for low back pain in a hospital setting. It is a self-administered questionnaire divided into ten sections designed to assess limitations of various activities of daily living. Each section is scored on a 0-5 scale, 5 representing the greatest disability. The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage. Thus, for every question not answered, the denominator is reduced by 5. If a patient marks more than one statement in a question, the highest scoring statement is recorded as a true indication of disability.
Outcome measures
| Measure |
IV Ketorolac
n=36 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=33 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=29 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Oswestry Disability Index
|
16.9 percentage
Standard Deviation 15.7
|
12.1 percentage
Standard Deviation 13.3
|
17.8 percentage
Standard Deviation 14.2
|
SECONDARY outcome
Timeframe: 1 year follow upRecord return to work
Outcome measures
| Measure |
IV Ketorolac
n=32 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=29 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=24 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Return to Work
Does not Apply
|
9 Participants
|
7 Participants
|
3 Participants
|
|
Return to Work
Early retirement
|
3 Participants
|
3 Participants
|
4 Participants
|
|
Return to Work
Complete disability
|
0 Participants
|
0 Participants
|
1 Participants
|
|
Return to Work
Lighter job
|
1 Participants
|
1 Participants
|
0 Participants
|
|
Return to Work
Original job, part time
|
2 Participants
|
2 Participants
|
0 Participants
|
|
Return to Work
Original job, full time
|
17 Participants
|
16 Participants
|
16 Participants
|
SECONDARY outcome
Timeframe: 1 year follow upPopulation: Patient treated Per-Protocol with completed follow-up
Validated pain scale; will be completed by patient Minimum Score: 0 \& Maximum score 100 A lower score is representative of a low pain level
Outcome measures
| Measure |
IV Ketorolac
n=27 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=23 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=17 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Numerical Pain Rating Scale
1-year - Best pain level
|
4 score on a scale
Interval 0.0 to 21.0
|
0 score on a scale
Interval 0.0 to 7.0
|
9 score on a scale
Interval 0.0 to 22.0
|
|
Numerical Pain Rating Scale
1-year - Worst pain level
|
11 score on a scale
Interval 0.0 to 41.0
|
8 score on a scale
Interval 0.0 to 25.0
|
25 score on a scale
Interval 6.5 to 45.5
|
|
Numerical Pain Rating Scale
1-year - Current pain level
|
6 score on a scale
Interval 0.0 to 28.0
|
7 score on a scale
Interval 0.0 to 20.0
|
13 score on a scale
Interval 0.5 to 26.5
|
SECONDARY outcome
Timeframe: 2 year follow upPopulation: Patient treated Per-Protocol with completed follow-up
The Veterans RAND 12 Item Health Survey (VR-12) is a brief, generic, multi-use, self-administered health survey comprised of 12 items. The instrument is primarily used to measure health related quality of life, to estimate disease burden and to evaluate disease-specific benchmarks with other populations. The 12 items in the questionnaire correspond to eight principal physical and mental health domains including general health perceptions; physical functioning; role limitations due to physical and emotional problems; bodily pain; energy-fatigue, social functioning and mental health.. The 12 items are summarized into two scores, a "Physical Health Summary Measure {PCS-physical component score}" and a "Mental Health Summary Measure {MCS-mental component score}". Score range is 0 to 100, higher score denotes a better outcome. This score range apply to both PCS and MCS.
Outcome measures
| Measure |
IV Ketorolac
n=26 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=23 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=23 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Veterans Rand - 12
PCS score
|
46.6 score on a scale
Standard Deviation 10.7
|
51.2 score on a scale
Standard Deviation 9.1
|
51.1 score on a scale
Standard Deviation 9.6
|
|
Veterans Rand - 12
MCS score
|
46.4 score on a scale
Standard Deviation 5.8
|
44.5 score on a scale
Standard Deviation 4.9
|
46.7 score on a scale
Standard Deviation 3.8
|
SECONDARY outcome
Timeframe: 2 year follow upPopulation: Patient treated Per-Protocol with completed follow-up
The Oswestry Disability Index (ODI) is the most commonly used outcome-measure questionnaire for low back pain in a hospital setting. It is a self-administered questionnaire divided into ten sections designed to assess limitations of various activities of daily living. Each section is scored on a 0-5 scale, 5 representing the greatest disability. The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage. Thus, for every question not answered, the denominator is reduced by 5. If a patient marks more than one statement in a question, the highest scoring statement is recorded as a true indication of disability.
Outcome measures
| Measure |
IV Ketorolac
n=27 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=25 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=25 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Oswestry Disability Index
|
14.7 percentage
Standard Deviation 14.5
|
11.4 percentage
Standard Deviation 11.6
|
16.0 percentage
Standard Deviation 15.1
|
SECONDARY outcome
Timeframe: 2 year follow upPopulation: Patient treated Per-Protocol with completed follow-up
Record return to work
Outcome measures
| Measure |
IV Ketorolac
n=25 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=24 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=26 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Return to Work
Does not Apply
|
5 Participants
|
8 Participants
|
7 Participants
|
|
Return to Work
Complete disability
|
0 Participants
|
0 Participants
|
1 Participants
|
|
Return to Work
Lighter job
|
0 Participants
|
0 Participants
|
0 Participants
|
|
Return to Work
Original job, part time
|
3 Participants
|
2 Participants
|
0 Participants
|
|
Return to Work
Original job, full time
|
12 Participants
|
9 Participants
|
15 Participants
|
|
Return to Work
Early retirement
|
5 Participants
|
5 Participants
|
3 Participants
|
SECONDARY outcome
Timeframe: 2 year follow upValidated pain scale; will be completed by patient Minimum Score: 0 \& Maximum score 100 A lower score is representative of a low pain level
Outcome measures
| Measure |
IV Ketorolac
n=23 Participants
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=20 Participants
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=22 Participants
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Numerical Pain Rating Scale
2 year - Best pain level
|
1 score on a scale
Interval 0.0 to 13.0
|
0 score on a scale
Interval 0.0 to 13.25
|
8.5 score on a scale
Interval 1.5 to 19.25
|
|
Numerical Pain Rating Scale
2 year - Worst pain level
|
13 score on a scale
Interval 0.0 to 37.0
|
1.5 score on a scale
Interval 0.0 to 28.5
|
18 score on a scale
Interval 8.0 to 50.0
|
|
Numerical Pain Rating Scale
2 year - Current pain level
|
4 score on a scale
Interval 0.0 to 41.0
|
3 score on a scale
Interval 0.0 to 23.5
|
12.5 score on a scale
Interval 0.0 to 30.5
|
Adverse Events
IV Ketorolac
Intravenous (IV) Placebo
IV Acetaminophen
Serious adverse events
| Measure |
IV Ketorolac
n=44 participants at risk
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 participants at risk
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 participants at risk
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Respiratory, thoracic and mediastinal disorders
Cardiopulmonary
|
2.3%
1/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Endocrine disorders
cardiovascular
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Injury, poisoning and procedural complications
Fall (mechanical)
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Injury, poisoning and procedural complications
Fall (syncope)
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Gastrointestinal disorders
Gastrointestinal
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Surgical and medical procedures
Implant-related
|
2.3%
1/44 • 2-year
|
4.7%
2/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Infections and infestations
Infection
|
0.00%
0/44 • 2-year
|
4.7%
2/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Musculoskeletal and connective tissue disorders
Musculoskeletal
|
13.6%
6/44 • 2-year
|
4.7%
2/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Nervous system disorders
Neurologic
|
6.8%
3/44 • 2-year
|
11.6%
5/43 • 2-year
|
24.4%
10/41 • 2-year
|
|
Surgical and medical procedures
Operative
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Musculoskeletal and connective tissue disorders
Radiographic
|
4.5%
2/44 • 2-year
|
4.7%
2/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Renal and urinary disorders
Renal
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Vascular disorders
Vascular
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Skin and subcutaneous tissue disorders
Wound
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
General disorders
Other
|
2.3%
1/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
Other adverse events
| Measure |
IV Ketorolac
n=44 participants at risk
IV Ketorolac arm
Ketorolac: Age 18-64: Intravenous Ketorolac 30 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
Age 65-75: Intravenous Ketorolac 15 milligrams (mg) every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
Intravenous (IV) Placebo
n=43 participants at risk
IV Placebo arm
Placebo: Intravenous Normal Saline every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
IV Acetaminophen
n=41 participants at risk
IV Acetaminophen arm
Acetaminophen: Intravenous Acetaminophen 1000mg every 6 hours for 48 hours in addition to patient-controlled analgesia and oral opioids as needed.
|
|---|---|---|---|
|
Respiratory, thoracic and mediastinal disorders
cardiopulmonary
|
22.7%
10/44 • 2-year
|
16.3%
7/43 • 2-year
|
19.5%
8/41 • 2-year
|
|
Endocrine disorders
cardiovascular
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Injury, poisoning and procedural complications
fall (mechanical)
|
2.3%
1/44 • 2-year
|
4.7%
2/43 • 2-year
|
4.9%
2/41 • 2-year
|
|
Injury, poisoning and procedural complications
fall (syncope)
|
2.3%
1/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Gastrointestinal disorders
gastrointestinal
|
34.1%
15/44 • 2-year
|
34.9%
15/43 • 2-year
|
19.5%
8/41 • 2-year
|
|
Surgical and medical procedures
implant-related
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Infections and infestations
infection
|
9.1%
4/44 • 2-year
|
0.00%
0/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Musculoskeletal and connective tissue disorders
musculoskeletal
|
29.5%
13/44 • 2-year
|
27.9%
12/43 • 2-year
|
14.6%
6/41 • 2-year
|
|
Nervous system disorders
neurologic
|
59.1%
26/44 • 2-year
|
41.9%
18/43 • 2-year
|
78.0%
32/41 • 2-year
|
|
Surgical and medical procedures
operative
|
2.3%
1/44 • 2-year
|
9.3%
4/43 • 2-year
|
0.00%
0/41 • 2-year
|
|
Musculoskeletal and connective tissue disorders
radiographic
|
0.00%
0/44 • 2-year
|
0.00%
0/43 • 2-year
|
2.4%
1/41 • 2-year
|
|
Renal and urinary disorders
renal
|
9.1%
4/44 • 2-year
|
30.2%
13/43 • 2-year
|
19.5%
8/41 • 2-year
|
|
Vascular disorders
vascular
|
0.00%
0/44 • 2-year
|
7.0%
3/43 • 2-year
|
9.8%
4/41 • 2-year
|
|
Skin and subcutaneous tissue disorders
wound
|
20.5%
9/44 • 2-year
|
2.3%
1/43 • 2-year
|
4.9%
2/41 • 2-year
|
|
General disorders
other
|
52.3%
23/44 • 2-year
|
53.5%
23/43 • 2-year
|
34.1%
14/41 • 2-year
|
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place