The Pharmacokinetics and Effectiveness of Local LevoBupivacaine Injection on Primary Total Joint Replacement Model.

June 2, 2024 updated by: Chang Gung Memorial Hospital

The Pharmacokinetics and Effectiveness of Different Methods of Local LevoBupivacaine Injection, a Prospective Randomized Case Control Clinical Study on Primary Total Joint Replacement Model.

Total joint replacement is an ideal procedure to treat end stage joint disease. Good post-op pain relief could accelerate patient recovery and rehabilitation, and decrease admission days and medical cost. Local injection of LevoBupivacaine is an effective method in post-operative pain control. The effectiveness of local analgesia was noticed clinically. However, thorough studies about the pharmacokinetics of LevoBupivacaine, maintenance of effect, influence of post-operative rehabilitation are not well studied in different way of injection. The purpose of this study is to evaluate and analyze the pharmacokinetics and effect of local Levobupivacaine injection in different ways, the amount of post-operative fentanyl requirement after local injection, time to first fentanyl request, pain score, immediate post-operative function, side effect of analgesic agents, and medical cost, and to improve the quality of total joint replacement post-operative care.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Single large dose of LevoBupivacaine had been proved good analgesic effect in total joint replacement surgery. However, the safety was not well studied. For better understanding the effect and safety of local analgesic agent, we choose LevoBupivacaine with different injection way to find out. We divide patient to three groups, for comparing the effectiveness of LevoBupivacaine, and safety of LevoBupivacaine by checking intra-blood concentration. The pre-emptive analgesics and post-operative analgesics were the same as routine protocol in other total joint replacement.

Study Type

Interventional

Enrollment (Actual)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Taoyuan City, Taiwan, 333
        • Chang Gung Memorial Hospital, Linkou

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Primary total joint replacement, no previous open surgery on the same joint
  2. Age 50~80 y/o, Pre-operative diagnosis: degenerative osteoarthritis
  3. Pre-operative deformity: varus <15°, valgus <15°, flexion contracture <15°.
  4. Patients with normal heart function
  5. Willing to receive post-operative questionnaire and outpatient clinic follow-up

Exclusion Criteria:

  1. Allergy to Patient-Controlled Analgesia or LevoBupivacaine
  2. Mental or cognitive illness that couldn't well response to questionnaire
  3. American Society Anesthesiologist more than III degree
  4. Liver cirrhosis, chronic renal insufficiency, heart disease or arrhythmia, insulin-dependent diabetes mellitus, and previous narcotic abuse history.
  5. Not suitable for using patient-controlled analgesia pump by evaluation of anesthesiologist

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Patient-Controlled Analgesia
Patient had no local analgesic agent during total joint replacement. Patient had baseline Patient-Controlled Analgesia pump.
Active Comparator: Peri-articular LevoBupivacaine
Patient had periarticular local analgesic agent, LevoBupivacaine Hydrochloride, during total joint replacement. Patient had baseline Patient-Controlled Analgesia pump.
Different way of LevoBupivacaine injection
Other Names:
  • Chirocaine
Experimental: Intra-articular LevoBupivacaine
Patient had intra-articular local analgesic agent, LevoBupivacaine Hydrochloride, during total joint replacement. Patient had baseline Patient-Controlled Analgesia pump.
Different way of LevoBupivacaine injection
Other Names:
  • Chirocaine

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Dosage of analgesic opioid agent
Time Frame: post-operative day2
The total dosage of opioid agent after local LevoBupivacaine injection
post-operative day2

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood concentration of LevoBupivacaine
Time Frame: 25min, 90min, and coming morning after LevoBupivacaine injection
Venous return of local LevoBupivacaine could cause the difference of blood concentration
25min, 90min, and coming morning after LevoBupivacaine injection

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Functional score
Time Frame: Baseline, Post-operative day1, day2, week2, week6, week12, week24
The difference of functional score
Baseline, Post-operative day1, day2, week2, week6, week12, week24

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Wei-Chen Lo, M.S., Chang Gung Memorial Hospital, Linkou, Taiwan

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 17, 2017

Primary Completion (Actual)

January 31, 2019

Study Completion (Actual)

May 31, 2019

Study Registration Dates

First Submitted

August 16, 2017

First Submitted That Met QC Criteria

August 22, 2017

First Posted (Actual)

August 23, 2017

Study Record Updates

Last Update Posted (Actual)

June 4, 2024

Last Update Submitted That Met QC Criteria

June 2, 2024

Last Verified

August 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • 201602050A3

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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