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Epidural Anesthesia Within an Enhanced Recovery Pathway in Reducing Pain in Patients Undergoing Gynecologic Surgery

This randomized clinical trial studies epidural anesthesia within an enhanced recovery pathway (ERP) in reducing pain in patients undergoing gynecologic surgery. An epidural analgesia (pain relief) is a small tube placed in the lower back that numbs the nerves and stops the feeling of pain. It stays in place for several days after surgery and may be helpful for pain control in patients with gynecologic cancer after surgery. ERP is a set of specific steps used before, during, and after surgery by health care providers to care for patients after surgery. ERPs include patient education, not using laxatives before surgery, increasing activity after surgery, and scheduled use of medications for pain and nausea. Giving epidural anesthesia as part of an ERP may improve pain control in patients undergoing gynecologic surgery.
Lisa Barroilhet, MD
Female
18 Years and over
Phase 3
This study is NOT accepting healthy volunteers
NCT02423876
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Inclusion Criteria:

• Patients undergoing gynecologic surgery via midline vertical laparotomy at University of Wisconsin Hospital and Clinics (UWHC)
• Patients must be English speaking
• Patients must have the ability to understand visual and verbal pain scales
• Patients must be eligible for epidural placement
Exclusion Criteria:

• Known allergy to local anesthetics
• Known history of chronic pain disorders and/or chronic opioid use defined as > 10 mg of oral (PO) morphine or equivalent used daily for at least 30 days prior to enrollment
• Patient is a prisoner or incarcerated
• Significant liver disease that would inhibit prescription of opioids
• Significant kidney disease that would inhibit administration of gabapentin
• Patient has a history of opioid dependence requiring rehabilitation or the use of opioid antagonists
• Patient is pregnant
• Patients with a planned exploration with biopsies (no organs removed) will be excluded from the study
Intraoperative Complication, Malignant Female Reproductive System Neoplasm, Pain, Cervix, Corpus Uteri, No Disease, Other Female Genital, Ovary, Uterus
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