The primary endpoint for this domain is the REMAP Periop primary outcome of hospital free days at 30 days after the elective surgical encounter.
Recommendations of Enhanced Recovery Interventions for Patient's Clinical Team and Collection of Associated Data
Neuraxial Analgesia (DRUG)This randomized group will receive a neuraxial morphine injection (intrathecal morphine/hydromorphone).
Regional Block 1: Paravertebral (DRUG)This randomized group will receive regional technique analgesia with sodium channel nerve blockade pharmacotherapy (ie nerve block)
Perphenazine (DRUG)This randomized group will receive 8 mg of perphenazine orally preoperatively.
Aprepitant (DRUG)This randomized group will receive 40 mg of aprepitant orally preoperatively.
Dimenhydrinate (DRUG)This randomized group will receive 25 mg of dimenhydrinate orally preoperatively.
Ondansetron 4 MG (DRUG)This randomized group will receive 4 mg of ondansetron orally.
Dexamethasone (DRUG)This randomized group will receive 4-5 mg of dexamethasone intravenously.
Regional Block 2: QL1 (DRUG)This randomized group will receive regional technique analgesia with sodium channel nerve blockade pharmacotherapy (ie nerve block)
Condition or Disease
- Perioperative Optimization
|Study results:||No Results Available|
|Age:||18 Years and older (Adult, Older Adult)|
Clinical Trial Dates
|Start date:||Apr 12, 2023||ACTUAL|
|Primary Completion:||Dec 30, 2024||ESTIMATED|
|Completion Date:||Dec 30, 2025||ESTIMATED|
|Study First Posted:||Oct 28, 2020||ACTUAL|
|Last Updated:||Jul 27, 2023|
Sponsors / Collaborators
The ERP domain under the Periop Core Protocol will evaluate the varying recommended combinations of perioperative treatments, in hopes to determine the optimal strategies for perioperative care based on surgery type and patient specific factors. In this study, patient care components within the preoperative, perioperative, and postoperative domains will be randomized with a machine learning REMAP technique. Optimal strategies combining the entire perioperative process will be analyzed that determine best outcomes for patients including hospital free days, reductions in postoperative nausea and vomiting, and improved pain control.
Pre-op -perphenazine Induction -dexamethasone Emergence -ondansetron
Pre-op * aprepitant * dimenhydrinate * perphenazine * ondansetron Induction -dexamethasone Emergence -ondansetron
IT morphine and QL1
IT morphine and paravertebral
|Age Groups:||Adult / Older Adult|
1. Patient is seen in preoperative appointment prior to surgery
2. Patient has been scheduled for a surgical type in which ERP has been implemented.
1. Death is deemed to be imminent or inevitable
2. Emergency surgical procedure without suitable lead-in time
3. Previous participation in this REMAP within the last 30 days, flagged by elective or emergency surgical encounter at UPMC in the past 30 days
4. Patient is pregnant
This clinical trial is recruiting
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Change in number of doses of antiemetics administered 24 hours post surgery.
Change in number of incidences of emesis 24h post surgery
Change in the rate (mg/day) of Oral Morphine Equivalents administered
Change in opioid prescription/administration following discharge
Readmission or complications due to surgery on or before 30 days of surgical procedure
Incidences of adverse events as define in core protocol