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Pain ManagementWALANTNCT06917118

Multimodal Pain Management After Wide Awake Local Anesthesia No Tourniquet Orthopedic Hand Surgery: A Randomized Control Trial

A study testing Oxycodone 5mg taken first, Acetaminophen and Naproxen Tablets, 500 mg in people with Pain Management, run by University of Puerto Rico at 1 site in Puerto Rico.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The main objective of the study is to measure the efficacy of a multimodal postoperative pain regimen consisting of oral acetaminophen and naproxen compared to a traditional opioid-only pain regimen following elective wide awake local anesthesia no tourniquet (WALANT) hand surgery in a Hispanic population. Read more about this study

Who is it for?
Ages 21 to 70 years
Conditions the study is for
Pain Management
What is being tested?
Oxycodone 5mg taken first, Acetaminophen and Naproxen Tablets, 500 mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
1 sitePuerto Rico
Study dates
1 May 2025to 1 Dec 2025
Phase
Interventional
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 21 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients 21-70 years of age undergoing outpatient hand surgery
  • Patients undergoing surgery with WALANT technique
  • Patients who provide written informed consent

Who cannot join

  • Patients aged 20 and younger, or 71 and older
  • Patient with chronic pain requiring opioid use
  • Pregnant patients
  • Patients who do not self-identify as Hispanic
  • Patients with known allergy to the medication
  • Patients with contraindications for the prescribed medications

Trial locations and contacts

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

Jose I Acosta Julbe, MD contact

+1 7873794119

jose.acosta14@upr.edu

Daniel E. Deliz Jiménez, BSc contact

+1 7872332369

daniel.deliz@upr.edu

Puerto Rico1 site
  • Oncological Hospital

    San Juan, PR, 00935

    Jose I Acosta Julbe, MD, +1 7873794119, jose.acosta14@upr.edu

Other trials in Puerto Rico

About this study

The main objective of the study is to measure the efficacy of a multimodal postoperative pain regimen consisting of oral acetaminophen and naproxen compared to a traditional opioid-only pain regimen following elective wide awake local anesthesia no tourniquet (WALANT) hand surgery in a Hispanic population. The study is a randomized control trial comparing the clinical outcomes of patients undergoing elective WALANT hand surgery performed by a board-certified, fellowship-trained orthopedic hand surgeon (Dr. Christian A. Foy).

The study groups are:

Read more
  • Control group: standard pain control with opioids
  • Experimental group: multimodal non-opioid pain control

Study Outcomes are:

  • VAS pain scores (7 days),
  • Total opioid usage
  • Patient satisfaction
  • Adverse events

We hypothesize that patients receiving multimodal pain regimens will report lower opioid use, lower pain scores, and greater satisfaction than patients receiving traditional opioid-only pain management.

Read the detailed description

The main objective of the study is to measure the efficacy of a multimodal postoperative pain regimen consisting of oral acetaminophen and naproxen compared to a traditional opioid-only pain regimen following elective wide awake local anesthesia no tourniquet (WALANT) hand surgery in a Hispanic population. The study is a single-blind, single-center randomized control trial comparing the clinical outcomes of patients undergoing elective WALANT hand surgery performed by a board-certified, fellowship-trained orthopedic hand surgeon (Dr. Christian A. Foy). Patients will be consecutively recruited at the center and randomized in a 1:1 ratio into the control and experimental groups. The control group will receive the standard of care for postoperative pain: 10 pills of 5mg oxycodone Q4hrs as needed. The experimental group will receive 30 pills of 500mg acetaminophen Q4hrs and 30 pills of 500mg naproxen Q4hrs until pain resolves or treatment is completed. The experimental group will also receive 5 tablets of 5mg oxycodone to take Q4hrs as needed for breakthrough pain. Postoperatively, daily pain Visual Analog Scale (VAS) scores, total opioid usage, patient satisfaction, and adverse events will be recorded. We hypothesize that patients receiving multimodal pain regimens will report lower opioid use, lower pain scores, and greater satisfaction than patients receiving traditional opioid-only pain management.

Conditions
Pain Management
Being tested
Oxycodone 5mg taken first, Acetaminophen, Naproxen Tablets, 500 mg, OxyCODONE 5 mg Oral Tablet
Keywords
WALANT, Multimodal analgesia, Nonopioid pain management, VAS pain scores
Medical subject headings
Agnosia

What participants receive

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

  • Oxycodone 5mg taken firstDrug

    10 pills of 5mg oxycodone Q4hrs as needed

  • AcetaminophenDrug

    30 pills of 500mg acetaminophen Q4hrs

  • Naproxen Tablets, 500 mgDrug

    30 pills of 500mg naproxen Q4hrs

  • OxyCODONE 5 mg Oral TabletDrug

    Only used for breakthrough pain

Study groups in NCT06917118
Study groupRoleWhat they receive
Standard Postoperative opioid analgesiaActive comparator10 pills of 5mg oxycodone Q4hrs as needed
Receives: Drug: Oxycodone 5mg taken first
Postoperative Opioid-sparing Multimodal analgesiaExperimental30 pills of 500mg acetaminophen Q4hrs and 30 pills of 500mg naproxen Q4hrs. Will also receive 5 tablets of 5mg oxycodone to take Q4hrs as needed for breakthrough pain
Receives: Drug: Acetaminophen; Drug: Naproxen Tablets, 500 mg; Drug: OxyCODONE 5 mg Oral Tablet

What is being measured

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

  1. VAS Pain Scores

    VAS pain scores will be assessed using a patient- completed VAS pain questionnaire until 7 days post-op. Patients will take the questionnaire home and report pain scores in the morning and in the afternoon every day for a week.

    Measured: From enrollment to the end of treatment at 7 days

  2. Patient Satisfaction

    Patient satisfaction will be assessed using the Patient Satisfaction Questionnaire Short Form (PSQ-18)

    Measured: From enrollment to the end of treatment at 7 days

  3. Total Opioid Usage

    Will be reported in as morphine milligram equivalents (MMEs)

    Measured: From enrollment to the end of treatment at 7 days

Secondary outcomes (3)
  1. Breakthrough Pain

    Breakthrough pain will be reported as a binary outcome (Y/N)

    Measured: From enrollment to the end of treatment at 7 days

  2. Length of Treatment

    Patients will be asked to report the number of days in which they used the provided pain control treatment

    Measured: From enrollment to the end of treatment at 7 days

  3. Indication for WALANT surgery

    We will report the indication for treatment for each patient to include in the final analysis

    Measured: From enrollment to the end of treatment at 7 days

Timeline

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

  1. First posted8 Apr 2025
  2. Study start1 May 2025 (estimated)
  3. Primary completion1 Nov 2025 (estimated)
  4. Study completion1 Dec 2025 (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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Care provider, Investigator, Outcomes assessor
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06917118
Sponsor's protocol ID
2501339638
Acronym
WALANT
Status last verified
Mar 2025
First submitted
31 Mar 2025
Last updated
8 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual Participant Data (IPD) will only be used internally by the study PI and primary investigators.

Publications

  • Abdullah S, Ahmad AA, Lalonde D. Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy. Plast Reconstr Surg Glob Open. 2020 Aug 11;8(8):e3023. doi: 10.1097/GOX.0000000000003023. eCollection 2020 Aug.

    PubMed 32983779
  • Burn MB, Shapiro LM, Eppler SL, Behal R, Kamal RN. Clinical Care Redesign to Improve Value for Trigger Finger Release: A Before-and-After Quality Improvement Study. Hand (N Y). 2021 Sep;16(5):624-631. doi: 10.1177/1558944719884661. Epub 2019 Nov 5.

    PubMed 31690136
  • Lalonde D, Bell M, Benoit P, Sparkes G, Denkler K, Chang P. A multicenter prospective study of 3,110 consecutive cases of elective epinephrine use in the fingers and hand: the Dalhousie Project clinical phase. J Hand Surg Am. 2005 Sep;30(5):1061-7. doi: 10.1016/j.jhsa.2005.05.006.

    PubMed 16182068
  • Chowdhry S, Seidenstricker L, Cooney DS, Hazani R, Wilhelmi BJ. Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010 Dec;126(6):2031-2034. doi: 10.1097/PRS.0b013e3181f44486.

    PubMed 20697319
  • Sawhney A, Thacoor A, Nagra R, Geoghegan L, Akhavani M. Wide Awake Local Anesthetic No Tourniquet in Hand and Wrist Surgery: Current Concepts, Indications, and Considerations. Plast Reconstr Surg Glob Open. 2024 Jan 22;12(1):e5526. doi: 10.1097/GOX.0000000000005526. eCollection 2024 Jan.

    PubMed 38260757
  • Deutsch CJ, Jones K, Dassayanake S, Milroy C. Concern about ischaemia drives a persistent and generation-spanning aversion to adrenaline in digital anaesthesia. JPRAS Open. 2021 Jan 26;28:61-63. doi: 10.1016/j.jpra.2021.01.006. eCollection 2021 Jun. No abstract available.

    PubMed 33732855
  • Fillingham YA, Hannon CP, Erens GA; AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup; Hamilton WG, Della Valle CJ. Acetaminophen in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty. 2020 Oct;35(10):2697-2699. doi: 10.1016/j.arth.2020.05.030. Epub 2020 May 26. No abstract available.

    PubMed 32571591
  • Padilla JA, Gabor JA, Schwarzkopf R, Davidovitch RI. A Novel Opioid-Sparing Pain Management Protocol Following Total Hip Arthroplasty: Effects on Opioid Consumption, Pain Severity, and Patient-Reported Outcomes. J Arthroplasty. 2019 Nov;34(11):2669-2675. doi: 10.1016/j.arth.2019.06.038. Epub 2019 Jun 26.

    PubMed 31311667
  • Gimbel JS, Brugger A, Zhao W, Verburg KM, Geis GS. Efficacy and tolerability of celecoxib versus hydrocodone/acetaminophen in the treatment of pain after ambulatory orthopedic surgery in adults. Clin Ther. 2001 Feb;23(2):228-41. doi: 10.1016/s0149-2918(01)80005-9.

    PubMed 11293556
  • Thompson KA, Klein D, Alaia MJ, Strauss EJ, Jazrawi LM, Campbell KA. Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study. Arthrosc Sports Med Rehabil. 2020 Dec 27;3(1):e15-e22. doi: 10.1016/j.asmr.2020.08.003. eCollection 2021 Feb.

    PubMed 33615243
  • Hess-Arcelay H, Claudio-Marcano A, Torres-Lugo NJ, Deliz-Jimenez D, Acosta-Julbe J, Hernandez G, Deliz-Jimenez D, Monge G, Ramirez N, Lojo-Sojo L. Opioid-Sparing Nonsteroid Anti-inflammatory Drugs Protocol in Patients Undergoing Intramedullary Nailing of Tibial Shaft Fractures: A Randomized Control Trial. J Am Acad Orthop Surg. 2024 Jun 15;32(12):e596-e604. doi: 10.5435/JAAOS-D-23-01014. Epub 2024 Apr 4.

    PubMed 38579315
  • American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012 Feb;116(2):248-73. doi: 10.1097/ALN.0b013e31823c1030. No abstract available.

    PubMed 22227789
  • Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg. 1997 Oct;85(4):808-16. doi: 10.1097/00000539-199710000-00017.

    PubMed 9322460
  • Pasero C, McCaffery M. Orthopaedic postoperative pain management. J Perianesth Nurs. 2007 Jun;22(3):160-72; quiz 172-3. doi: 10.1016/j.jopan.2007.02.004.

    PubMed 17543801
  • Trasolini NA, McKnight BM, Dorr LD. The Opioid Crisis and the Orthopedic Surgeon. J Arthroplasty. 2018 Nov;33(11):3379-3382.e1. doi: 10.1016/j.arth.2018.07.002. Epub 2018 Jul 11.

    PubMed 30075877

Questions about this trial

What is this clinical trial studying?

A study testing Oxycodone 5mg taken first, Acetaminophen and Naproxen Tablets, 500 mg in people with Pain Management, run by University of Puerto Rico at 1 site in Puerto Rico.

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 3 inclusion and 6 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: opening soon, as of the sponsor's last update on 8 Apr 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 Puerto Rico. 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.

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?

Contact Jose I Acosta Julbe, MD (+1 7873794119, jose.acosta14@upr.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

VAS Pain Scores (time frame: From enrollment to the end of treatment at 7 days). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06917118, which also lists 20 linked publications.

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 8 Apr 2025.

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