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

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

178 participants

Primary outcome timeframe

Hospital stay (2-4 days)

Results posted on

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

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

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

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

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 weeks

Population: Patient treated Per-Protocol with completed follow-up

Track opioid use after discharge for the first 4-6 weeks

Outcome measures

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 months

Population: 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

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 year

Population: 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

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 years

Population: 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

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 days

Population: 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

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 days

Population: 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

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

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

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

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

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

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-operative

Population: 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

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-operative

Population: 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

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 up

Population: 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

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 up

Population: 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

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 up

Population: Patient treated Per-Protocol with completed follow-up

Record return to work

Outcome measures

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 up

Population: 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

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 up

Population: 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

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 up

Record return to work

Outcome measures

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 up

Population: 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

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 up

Population: 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

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 up

Population: 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

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 up

Population: Patient treated Per-Protocol with completed follow-up

Record return to work

Outcome measures

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 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

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

Serious events: 10 serious events
Other events: 40 other events
Deaths: 0 deaths

Intravenous (IV) Placebo

Serious events: 9 serious events
Other events: 40 other events
Deaths: 0 deaths

IV Acetaminophen

Serious events: 11 serious events
Other events: 38 other events
Deaths: 0 deaths

Serious adverse events

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

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

Catherine Himo Gang

HospitalSS

Phone: 917-260-4603

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place