No Opioids vs. Minimal Opioids Following Inguinal Hernia Repair

NCT ID: NCT05929937

Last Updated: 2025-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

904 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-10

Study Completion Date

2027-07-31

Brief Summary

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The investigators hypothesize that not prescribing opioids after uncomplicated, outpatient IHR will be non-inferior to prescribing opioids (5 tablets of Oxycodone, 5mg; or surgeon preference for intolerance) with respect to requests for opioid refills. Additionally, the investigators believe there will be no significant difference in postoperative readmission for pain quality of life at 30 days in either group.

Detailed Description

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Patients presenting with primary or recurrent inguinal hernias, previously repaired in an open fashion, will be considered eligible to be enrolled in this study. Exclusion criteria include patients who cannot tolerate general anesthesia, opioids or NSAIDS, surgeries requiring extensive dissection/hernia sac reduction, or additional procedures, patients requiring inpatient admission postoperatively, and patients who are not able to understand and sign a written consent form. Surgeons will notify a study coordinator at the end of surgery for randomization. Patients will be randomized to opioids versus no opioids at the end of surgery and stratified based on unilateral versus bilateral inguinal hernia repair. The intervention will be not prescribing opioids post-operatively. If patients require prescription for opioids after randomization for uncontrolled pain for the no opioid group, the patient will remain in the intervention group and will be treat as intention to treat which will be recorded in REDCap®. All patients in the study will receive prescriptions for Acetaminophen and Ibuprofen. No other intraoperative or postoperative differences will occur between the two groups.

Baseline information, operative details, and 30-day outcomes are already captured within the ACHQC database, allowing for follow-up, and data capture with decreased effort outside of routine care. Randomization data will be captured and stored in REDCap®.

Baseline patient demographics will be obtained at initial patient recruitment, and baseline ACHQC questionnaires will be completed following patient recruitment. All operative details are already routinely collected and stored in the ACHQC database. Patient-reported quality of life will also be assessed at baseline and at 30 days using the EuraHS Quality Of Life survey tool, which is collected for all patients entered into the ACHQC as part of the ACHQC Inguinal Hernia Postoperative Assessment. Patients will be required to complete these forms at each clinic visit, or via telephone contact, as this is standard procedure for all patients entered into the ACHQC. At the time of the one-month follow-up clinic visits, a routine physical examination will be performed on all patients.

Outcomes to be investigated:

* Specific Aim #1: To determine if the use of post-operative use of opioids results in a difference in rate of opioid refills/requests when compared to those not initially prescribed opioids.
* Specific Aim #2: To determine if the use of post-operative use of opioids results in a difference in Patient-Reported Outcome Measurement Information System (PROMIS Pain Intensity) scores at the 1 month follow up visit post-operatively when compared to those not prescribed opioids.
* Specific Aim #3: To determine if the use of post-operative use of opioids results in a difference in EuraHS (European registry for abdominal wall hernias) Quality of Life (QoL) scores at the 1 month follow up visit post-operatively when compared to those not prescribed opioids.
* Specific Aim #4: To determine if the use of post-operative use of opioids results in a difference in all 30-day complications when compared to those not prescribed opioids.

Conditions

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Postoperative Pain Inguinal Hernia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients will be assigned to receive 5 tablets of Oxycodone (5mg) or none
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Minimal Opioids

Standard of care 5 tablets of Oxycodone (5mg) every 6 hours as needed for pain

Group Type OTHER

Opioids

Intervention Type DRUG

Patients will receive a prescription of 5 tablets of opioids (preferred: Oxycodone, or surgeon preference for Oxycodone intolerance)

No opioids

Standard of care

Group Type OTHER

No opioids

Intervention Type OTHER

Standard of care, patients will not receive a prescription for opioids.

Interventions

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Opioids

Patients will receive a prescription of 5 tablets of opioids (preferred: Oxycodone, or surgeon preference for Oxycodone intolerance)

Intervention Type DRUG

No opioids

Standard of care, patients will not receive a prescription for opioids.

Intervention Type OTHER

Other Intervention Names

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Opioid

Eligibility Criteria

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Inclusion Criteria

* Adult patients aged 18 years or older
* Patients undergoing elective unilateral or bilateral inguinal hernia repairs
* Patients able to tolerate general anesthesia

Exclusion Criteria

* Patients who cannot tolerate general anesthesia,
* Patients who cannot tolerate opioids or NSAIDS,
* Patients on opioids for chronic pain management (defined as near daily use within 90 days),
* Patients who undergo surgeries requiring extensive dissection/hernia sac reduction, or additional procedures,
* Patients requiring inpatient admission postoperatively
* Patients who are not able to understand and sign a written consent form
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Clayton Petro

OTHER

Sponsor Role lead

Responsible Party

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Clayton Petro

Assistant Professor of Surgery Lerner College of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Clayton C Petro, MD

Role: PRINCIPAL_INVESTIGATOR

The Cleveland Clinic

Locations

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MemorialCare

Fountain Valley, California, United States

Site Status RECRUITING

Corewell Health

Royal Oak, Michigan, United States

Site Status RECRUITING

University Hospitals

Cleveland, Ohio, United States

Site Status RECRUITING

Cleveland Clinic Center for Abdominal Core Health

Cleveland, Ohio, United States

Site Status RECRUITING

Prisma Health

Greenville, South Carolina, United States

Site Status RECRUITING

University of Tennessee Medical Center

Knoxville, Tennessee, United States

Site Status RECRUITING

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status RECRUITING

North York General Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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United States Canada

Central Contacts

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Clayton C Petro, MD

Role: CONTACT

Phone: 216 445-0053

Email: [email protected]

Noah Tocci, MD

Role: CONTACT

Phone: 216-3416-1447

Email: [email protected]

Facility Contacts

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Todd Harris, MD

Role: primary

Study Coordinator

Role: primary

Joshua Lyons, MD

Role: primary

Clayton C Petro, MD

Role: primary

Study Coordinator

Role: primary

Kaela E. Blake, MD

Role: primary

Rana Higgins, MD

Role: primary

Megan Melland-Smith, MD

Role: primary

Other Identifiers

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23-189

Identifier Type: -

Identifier Source: org_study_id