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Pain, PostoperativePhase 4NCT05231460

Pain Management Study

A Phase 4 study testing Active Comparator: narcotic regimen with TAP block, Active Comparator: narcotic regimen with no TAP block and non-narcotic regimen with TAP block in people with Pain, Postoperative, run by University of Arizona at 1 site in United States.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

This study aims to better understand the role that narcotic vs. non-narcotic multimodal pain management play in patients' pain following bariatric surgery (Laproscopic Surgery and Robotic Assisted Surgery). Participation in this study will last approximately 90 days following surgery. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Pain, Postoperative
What is being tested?
Active Comparator: narcotic regimen with TAP block, Active Comparator: narcotic regimen with no TAP block and non-narcotic regimen with TAP block
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
244 participants
Where
1 siteUnited States
Study dates
18 Feb 2022to Jun 2026
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Laparoscopic or Robotic Sleeve Gastrectomy bariatric surgery scheduled electively from the BUMCP Bariatric Clinic
  • BMI>35kg/m2
  • Patient of Principal Investigator or Co-Investigator
  • 18 years or older

Who cannot join

  • Chronic Pain Management on narcotics at New Patient visit or placed on narcotics prior to surgery
  • Re-operative bariatric surgery procedures
  • Admitted to the ICU after surgery
  • Unable to walk 200ft
  • Allergic to narcotics, steroids, or other medications used in the protocol
  • Use of insulin to treat diabetes
Show all 11Show fewer
  • Chronic Kidney Disease - stage 4 or greater
  • Significant hepatic disease
  • Carries a diagnosis of Pulmonary Hypertension
  • Carries a diagnosis of Congestive Heart Failure
  • Pregnant

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site
  • Banner University Medical Center Phoenix

    Phoenix, Arizona, 85006

Other trials in United States

About this study

Official title: Do Experience of Pain and 30-Day Surgery Outcomes Differ in Robotic Bariatric Surgery Patients Treated With Narcotic vs. Non-narcotic Pain Management Protocols?

This study aims to better understand the role that narcotic vs. non-narcotic multimodal pain management play in patients' pain following bariatric surgery (Laproscopic Surgery and Robotic Assisted Surgery). Participation in this study will last approximately 90 days following surgery. During that 90 day period, participants will be asked to report pain and nausea every 4 hours to a study coordinator or nurse while they are recovering in the hospital. Following discharge from the hospital patients will be asked to report pain, nausea, and any medical changes 7 days, 30 days, and 90 days from surgical date.

The procedures and medications used in this study are FDA approved medical therapies and are part of Standard of Care for this population. This study aims to therapeutically investigate efficacy of the proposed pain management regimens. The procedures and individual medications are not the subject of research as they are considered routine well established and documented interventions for obesity and the treatment of post operative pain.

Read the detailed description

The majority of patients who undergo surgery will require treatment for the management of acute post-surgical pain. The use of narcotics after elective surgical procedures has contributed to the current opioid epidemic. Striking the right balance of treatment and use of narcotics vs. non-narcotic medications is at a crucial juncture in surgery.

Post-surgical pain influences a patient's perception of quality of care, physical recovery, and length of stay. The threat of poor postoperative pain control is a fear of many patients who will have a surgical procedure. The post- operative pain regimen is traditionally chosen by the operating surgeon rather than in a shared decision-making model where patients are educated about choice and participate in management. This is one of many factors influencing use of medications for post-operative pain. If a patient develops longer term, chronic postsurgical pain it may lead to disability and diminish quality of life, increase healthcare utilization, increase healthcare costs, and result in loss of productivity.

Morbid obesity is a global epidemic that increases the risk of developing related complications such as cardiac failure, type 2 diabetes, hypertension, hyperlipidemia, degenerative joint disease with the development of chronic pain and decreased mobility, and sleep apnea. In 2013 and 2014, 50% of the population had or had been affected by obesity, defined as a BMI ≥30mg/kg2. An established and effective treatment for weight loss is elective bariatric surgery.

Laparoscopic bariatric surgery (>90% of cases) is associated with less postoperative pain than open surgery, however, opioids are still used frequently for analgesia. Opioid analgesia comes with many side effects including nausea, constipation, risk of postoperative ileus, hypopnea, hypoxemia, delayed ambulation and mortality. This patient population is at increased risk for hypoventilation and narcotic related post-operative complications.

In the BUMCP department of bariatric surgery, we began employing a post-operative multimodal pain control protocol in November of 2017 and noticed improvement in pain control, declining levels of nausea and a decrease in the length of stay with our patient population. All medications and surgical interventions are considered approved standard of care in surgery. Previous studies have shown that employing a multimodal pain control protocol, even intraoperatively, influences postoperative pain control, nausea, emesis as well as chronic postoperative pain. In mid-2018 we began offering patients tap blocks which we believe have offered patients more consistent post- operative pain control.

Postsurgical pain control is imperative as it influences a patient's quality of care and life, recovery, and length of stay. Poor pain control can not only lead to increased healthcare utilization/costs, whereas use of opioid analgesia comes with side effects including nausea, constipation, risk of postoperative ileus, hypopnea, hypoxemia, delayed ambulation, mortality, and the increased possibility of long-term narcotic addiction. In the population that suffers from obesity it is desirable to reduce the narcotics being used as they are at increased risk for hypoventilation and post-operative complications. The BUMCP bariatric surgery department began employing a post-operative multimodal pain control protocol and noticed improvement in pain control, a decrease in perioperative morbidity from narcotic use and a decreased length of stay in the elective patient population undergoing primary bariatric surgery. This study will contribute to our knowledge of whether a non-narcotic, multi-modal post-operative pain management protocol is equivalent, if not superior in multiple facets compared to narcotic use.

Objectives

Study Hypothesis:

The use of a multi-modal, non-narcotic pain management regimen in postoperative bariatric patients will have equivalent, if not superior, postoperative outcomes compared with patient receiving narcotic pain management regimen. Those patients receiving a TAP block will have better pain control in the first 24 hours post-op.

Primary outcome measure:

Patient reported postoperative pain using the Wong Baker Faces pain scale (mean of all reported scores till the earlier of discharge and 24 hours postoperative).

Secondary outcomes measures:

  • Postoperative nausea numerical rating scale (0-5)
  • Length of time before subject can complete 200 feet of ambulation post-op
  • Hospital length of stay
  • Readmissions for pain control up to 30-day postoperatively (as binary Yes/No and also as a count variable)
Being tested
Active Comparator: narcotic regimen with TAP block, Active Comparator: narcotic regimen with no TAP block, non-narcotic regimen with TAP block, non-narcotic regimen with no TAP block
Keywords
Transversus Abdominis Plane (TAP) Block, Bariatric Surgery, Pain, post-operative, Analgesics, Non-Narcotic, Analgesics, Narcotic, Sleeve gastrectomy, Gastric Sleeve, Postoperative Complications
Medical subject headings
Pain, Postoperative, Bites and Stings, Postoperative Complications

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Active Comparator: narcotic regimen with TAP blockDrug

    Patient will receive Tap Block to 15ml of 0.5% Ropivacaine and will be administered the following Narcotic Pain Regimen post-operatively:

    • PO Oxycodone 5mg, 10mg q4h for moderate and severe pain
    • IV Dilaudid 1mg q3h for breakthrough pain
  • Active Comparator: narcotic regimen with no TAP blockDrug

    Patient will not receive TAP block and will be administered the following Narcotic Pain Regimen post-operatively:

    • PO Oxycodone 5mg, 10mg q4h for moderate and severe pain
    • IV Dilaudid 1mg q3h for breakthrough pain
  • non-narcotic regimen with TAP blockDrug

    Patient will receive Tap Block to 15ml of 0.5% Ropivacaine and will be administered the following Non-narcotic Pain Regimen post-operatively:

    • Toradol 15mg q6h
    • Tylenol 1000mg q8h
    • Gabapentin 100mg three times a day
  • non-narcotic regimen with no TAP blockDrug

    Patient will not receive TAP block and will be administered the following Non-narcotic Pain Regimen post-operatively:

    • Toradol 15mg q6h
    • Tylenol 1000mg q8h
    • Gabapentin 100mg three times a day
Study groups in NCT05231460
Study groupRoleWhat they receive
narcotic regimen with TAP blockActive comparatorPatient will receive Tap Block and will be administered the Narcotic Pain Regimen post-operatively
Receives: Drug: Active Comparator: narcotic regimen with TAP block
narcotic regimen with no TAP blockActive comparatorPatient will not receive TAP block and will be administered the Narcotic Pain Regimen post-operatively
Receives: Drug: Active Comparator: narcotic regimen with no TAP block
non-narcotic regimen with TAP blockActive comparatorPatient will receive Tap Block and will be administered Non-narcotic Pain Regimen post-operatively
Receives: Drug: non-narcotic regimen with TAP block
non-narcotic regimen with no TAP blockActive comparatorPatient will not receive TAP block and will be administered Non-narcotic Pain Regimen post-operatively
Receives: Drug: non-narcotic regimen with no TAP block

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. postoperative pain

    Patient reported postoperative pain using the Wong Baker Faces pain scale. The scale shows a series of six faces ranging from a happy face at 0, or "no hurt", to a crying face at 10, which represents "hurts like the worst pain imaginable. Based on the faces and written descriptions, the patient chooses the face that best describes their level of pain.

    Measured: discharge or 24 hours postoperative, whichever is first

Secondary outcomes (4)
  1. Postoperative nausea

    Postoperative nausea defined by numerical rating scale (0-5)

    Measured: post-operative until patient discharge or up to 90 days, whichever comes first

  2. 200 foot ambulation

    Length of time before subject can complete 200 feet of ambulation post-op

    Measured: post-operative until patient discharge or up to 90 days, whichever comes first

  3. Hospital length of stay

    Patient's length of stay in the hospital

    Measured: post-operative until patient discharge or up to 90 days, whichever comes first

  4. Readmissions

    Readmissions for pain control

    Measured: up to 30-day postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Feb 2022
  2. Study start18 Feb 2022
  3. Primary completionJun 2026 (estimated)
  4. Study completionJun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Model description
Each subject will be randomized at 1:1 ratio to receive either the Narcotic Pain Regimen or the Non-narcotic Pain Regimen and will also be randomized at 1:1 ratio to receive either TAP block or no TAP block. Eligible subjects will therefore be randomized to one of four arms with approximately equal sizes:1) narcotic regimen with TAP block; 2) narcotic regimen with no TAP block; 3) non-narcotic regimen with TAP block; 4) non-narcotic regimen with no TAP block. The primary comparison will be between narcotic and non-narcotic regimens (arms 1 and 2 combined versus arms 3 and 4 combined). Comparison of TAP block versus no TAP block (arms 1 and 3 combined versus arms 2 and 4 combined) will performed as a secondary analysis.
Masking
None (open label)
Enrolment
244 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05231460
Sponsor's protocol ID
2108122253
Status last verified
Aug 2025
First submitted
21 Dec 2021
Last updated
24 Aug 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Data will not be retained for future use. Data will not be shared with collaborating entities nor sold/shared with pharmaceutical companies

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Active Comparator: narcotic regimen with TAP block, Active Comparator: narcotic regimen with no TAP block and non-narcotic regimen with TAP block in people with Pain, Postoperative, run by University of Arizona at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 24 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

postoperative pain (time frame: discharge or 24 hours postoperative, whichever is first). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Aug 2025.

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