Trial Assessing Maternal Post-Partum Pain (CRAMPS)
The routine use of belladonna/opium (B&O) suppositories will improve patient's self-reported pain control in the first 24-hours after delivery.
Commonly employed methods of controlling post-partum pain include opioid analgesics, non-steroidal anti-inflammatories, acetomenophen, and topical analgesics. Pain medication is generally administered via oral or IV route. Several studies have investigated suppositories as an alternative method of improving pain following delivery.
Rectal analgesia provides a means of improving pain control through local effects on the perineum and uterus while possibly decreasing systemic absorption, which may in turn decrease systemic side effects and transmission to the newborn infant through breast milk. B&O suppositories contain two medications that could potentially decrease post-partum pain. This quality may significantly improve pain from uterine contractions during the post-partum period.
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||CRAMPS Trial: Controlled Randomized Trial Assessing Maternal Post-partum Pain With Suppositories|
- Pain level twenty four hours after delivery [ Time Frame: Twenty four hours ]The primary outcome will be pain as measured for 24-hours after delivery. Patients will be asked to report a Visual Analog Scale (VAS) pain score at 8, 16, and 24 hours after delivery. This score will be recorded by the patients' nurse at time of administration of next dose.
- Additional pain medication [ Time Frame: twenty four hours ]The number of additional medication administrations beyond B&O suppositories will be recorded.
- Patient Satisfaction [ Time Frame: Twenty four hours after surgery ]Patient satisfaction with pain control during hospital stay based on survey completed at discharge.
- Side effects [ Time Frame: Twenty four hours after delivery ]Frequency of side effects, (including drowsiness, dry mouth, urinary retention, photophobia, rapid pulse, dizziness, blurred vision, constipation, nausea, vomiting, pruritis and urticaria) based on survey to be completed at time of discharge
|Study Start Date:||May 2009|
|Study Completion Date:||September 2011|
|Primary Completion Date:||September 2011 (Final data collection date for primary outcome measure)|
Placebo Comparator: Control group
Study participants randomly assigned to the control group will receive routine post-partum pain management per physician preference. Typical post-partum prescriptions for pain at our institutions generally include Norco or Tylenol # 3 and Motrin as needed. Intraveneous Toradol is often given to patients for 24 hours following cesarean deliveries. Post-partum pain medications sometimes include oral Tramadol as well as Epifoam and Dermaplast topical anesthetics. In addition, patients will be given a vegetable oil suppository (placebo) per rectum immediately after delivery, then scheduled every 8-hours for the first 24 hours.
Other: Control Group
A vegetable oil suppository (placebo) per rectum immediately after delivery, then scheduled every 8-hours for the first 24 hours.
Active Comparator: B&O Suppository group
Study participants randomly assigned to the intervention group will be given a B&O suppository 16.2mg/30mg per rectum immediately after delivery, then every 8 hours for 24 hours following delivery in addition to routine post-partum pain management per physician preference.
Drug: B&O suppository
B&O suppository 16.2mg/30mg per rectum immediately after delivery, then every 8 hours for 24 hours following delivery
Please refer to this study by its ClinicalTrials.gov identifier: NCT01271855
|United States, Illinois|
|Loyola Univeristy Medical Center|
|Maywood, Illinois, United States, 60153|
|Gottlieb Memorial Hospital|
|Melrose Park, Illinois, United States, 60160|
|Principal Investigator:||Kimberly Kenton, M.D.||Loyola University|