Pain Medication for Postoperative Pain

(CARES Trial)

This trial compares two common pain relief methods for surgeries such as gallbladder removal, hernia repair, or breast lump removal. It aims to determine which is more effective: NSAIDs (a type of pain reliever) plus acetaminophen, or low-dose opioids plus acetaminophen. Researchers believe the NSAID option might be more effective and cause fewer side effects. Individuals who have not used pain medications extensively before surgery and are planning one of these specific surgeries might be suitable for the trial. As a Phase 4 trial, the treatments are already FDA-approved and proven effective, allowing researchers to understand how they benefit more patients.

The trial requires that you have not used significant pain medications like opioids or NSAIDs recently. If you've used these medications frequently in the past 30 days, you may not be eligible to participate.

Research shows that both NSAIDs and opioids have been studied for post-surgery pain relief. NSAIDs, such as ibuprofen and meloxicam, are generally safe for managing short-term pain when used correctly. Studies indicate that NSAIDs have minor side effects similar to other pain medications, without significantly increasing wound problems.

In contrast, opioids often cause more noticeable side effects, including dizziness, drowsiness, nausea, and vomiting. One study found that some opioids, like tramadol, had higher rates of serious side effects compared to others, such as oxycodone and hydrocodone.

Researchers are excited about these treatments for postoperative pain because they explore different approaches to pain management. The NSAID regimen offers a non-opioid alternative, which could reduce the risk of dependency and side effects associated with opioids. The opioid regimen is being examined to potentially optimize dosing and minimize adverse effects. By comparing these two regimens, researchers hope to find effective pain relief options that improve patient recovery while minimizing risks.

In this trial, participants will be assigned to different treatment arms to manage postoperative pain. Research has shown that combining NSAIDs (a type of pain reliever) with acetaminophen often manages pain after surgery better than opioids. Participants in the NSAID regimen arm may experience effective pain relief with fewer side effects. Studies have found that NSAIDs can relieve pain more effectively and with fewer side effects. For instance, a review found that NSAIDs worked better than weaker opioids for post-surgery pain. Meanwhile, participants in the opioid regimen arm may find opioids effective, but there is concern about long-term use. Additionally, some opioids may not reduce pain as well as NSAIDs after surgery. Overall, NSAIDs appear to be a safer and more effective choice for many patients.¹²³⁵⁶