Liposomal Bupivacaine With Standard Bupivacaine Versus Dexmedetomidine With Standard Bupivacaine
Liposomal Bupivacaine With Standard Bupivacaine Versus Dexmedetomidine With Standard Bupivacaine for Supraclavicular Brachial Plexus Block in Distal Radial Fracture Surgery: a Randomized Controlled Trial.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Stanley SC Wong, MD
- Phone Number: 22553303
- Email: wongstan@hku.hk
Study Locations
-
-
-
Hong Kong, Hong Kong
- The University of Hong Kong
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion criteria
- American Society of Anesthesiologist (ASA) status I-III
- Age 18-90 years old
- Scheduled for distal radial fracture fixation (Open reduction and internal fixation with volar approaching locking plate)
- Patients with informed consent to participate in the study
Exclusion criteria
- Revision surgery
- Previous fractures or surgery in the affected distal radius
- Surgery involving more than the affected arm
- Higher energy and high-grade fracture cases - road traffic accident, fall from height, open fractures, combined distal radius and distal ulna fractures, fractures requiring external fixation, fractures with severe articular comminution or severe metaphyseal extension, comminuted fractures requiring more than a single volar approach incision and a single volar locking plate implant
- Cases with painful conditions affecting the upper limb prior to surgery such as cervical spine, shoulder, elbow, other hand and wrist problems
- Cases with baseline (pre-injury) QuickDASH score worse than 10 out of 100
- Respiratory compromise (requires long term oxygen)
- History of seizures
- Pre-existing neurological disorder/deficit
- Chronic opioid user (3 months or more)
- Presence of chronic pain condition (pain duration over 3 months)
- Alcohol or substance abuse
- Psychiatric illness
- Impaired mental state
- Local infection
- Allergy to analgesic drugs: local anaesthetic drugs, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioids
- Impaired renal function (defined as effective glomerular filtration rate <30ml/min/1.73m2
- Impaired liver function (defined as plasma bilirubin over 34μmol/L; international normalized ratio [INR] ≥1.7, alanine aminotransferase [ALT] over 100U/L, aspartate aminotransferase [AST] over 100U/L)
- Coagulopathy (platelet count <100,000/ml and/or INR ≥1.5) or the use of anticoagulants (not including aspirin) that precludes the use of supraclavicular BPB
- Pregnancy
- Patient refusal for regional nerve blocks
- Patient refusal to join the clinical trial
- Patient unable/unwilling to attend post-op rehabilitation programme
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: To receive supraclavicular BPB using liposomal bupivacaine with standard bupivacaine
10ml of 0.5% plain bupivacaine and 10ml of 1.33% liposomal bupivacaine will be injected.
|
Bupivacaine liposome is a multivesicular formulation of bupivacaine that allows rapid absorption and prolonged release of bupivacaine.
|
|
Active Comparator: To receive supraclavicular BPB using dexmedetomidine with standard bupivacaine
19.5ml of 0.5% plain bupivacaine and 0.5ml (50mcg) of dexmedetomidine will be injected.
|
Dexmedetomidine is a full α₂ adrenergic receptor agonist roughly eight times more selective for the α₂ receptor than clonidine.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Weighted area under curve (AUC) pain score at rest
Time Frame: 0-48 hours after surgery
|
Pain severity would be rated at rest after surgery using numerical rating scale (NRS) with 0 to 10 where 0=no pain and 10=the worst possible pain
|
0-48 hours after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Acute Pain
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Anesthetics, Local
- Anesthetics
- Central Nervous System Depressants
- Sensory System Agents
- Analgesics, Non-Narcotic
- Analgesics
- Neurotransmitter Agents
- Hypnotics and Sedatives
- Adrenergic alpha-2 Receptor Agonists
- Adrenergic alpha-Agonists
- Adrenergic Agonists
- Adrenergic Agents
- Bupivacaine
- Dexmedetomidine
Other Study ID Numbers
Other Study ID Numbers
- UW24-024
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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