Postoperative Non-Opioid Pain Management Utilizing Local Anesthetics Coupled With Modulated Coagulation
A Randomized, Single-Blinded, Controlled Study Evaluating Postoperative Non-Opioid Pain Management Utilizing Local Anesthetics Coupled With Modulated Coagulation
This study is a prospective randomized trial examining the effect of tranexamic acid (TXA) and aminocaproic acid (ε-Ahx) with local anesthetics and thrombin in all electively created surgical wound beds in hand surgery to provide long term pain relief and decrease the use of postoperative narcotics.
All surgical created wounds for any hand surgery will be treated in a randomized fashion with the following four arms:
- Bupivacaine + lidocaine
- Bupivacaine + lidocaine + thrombin
- Bupivacaine + lidocaine + thrombin + tranexamic acid
- Bupivacaine + lidocaine + thrombin + aminocaproic acid
All are applied topically to surgical bed prior to closure of skin.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Tom Calahan
- Phone Number: 929-455-5826
- Email: Thomas.Calahan@nyulangone.org
Study Locations
-
-
New York
-
New York, New York, United States, 10016
- NYU Langone Health
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 or older
- Any patient undergoing elective hand surgery
Exclusion Criteria:
- Any patient with a traumatic or infected open wound (only surgically created wounds will be included)
- History of chronic pain
- History of narcotic addiction
- History of recreational drug dependency
- History of psychiatric pathology
- Allergy or hypersensitivity to local anesthetics, recombinant human thrombin or tranexamic acid
- History of coagulopathy or active thromboembolic disease
- Any patient receiving a supra/infraclavicular block for anesthesia
- Pregnancy
- Hypersensitivity to hamster proteins
- History of seizures
- Significant renal impairment (chronic kidney disease stage 3 or greater)
- History of retinal vascular disease or history of unexplained visual symptoms
- Active upper urinary tract bleeding
- History of known hypercoagulable disorder, prior thromboembolic events, or active clotting disorders
- History of severe hepatic dysfunction (active hepatitis or steatohepatitis, hepatic fibrosis considered cirrhosis)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Bupivacaine + lidocaine
Surgical created wounds for any hand surgery will be treated with bupivacaine + lidocaine.
|
5 ml of 0.25% bupivacaine
5 ml of 1% lidocaine
|
|
Experimental: Bupivacaine + lidocaine + thrombin
Surgical created wounds for any hand surgery will be treated with bupivacaine + lidocaine + thrombin.
|
5 ml of 0.25% bupivacaine
5 ml of 1% lidocaine
10000 units of thrombin
|
|
Experimental: Bupivacaine + lidocaine + thrombin + tranexamic acid
Surgical created wounds for any hand surgery will be treated with bupivacaine + lidocaine + thrombin + tranexamic acid.
|
5 ml of 0.25% bupivacaine
5 ml of 1% lidocaine
10000 units of thrombin
500 mg of tranexamic acid
|
|
Experimental: Bupivacaine + lidocaine + thrombin + aminocaproic acid
Surgical created wounds for any hand surgery will be treated with bupivacaine + lidocaine + thrombin + aminocaproic acid.
|
5 ml of 0.25% bupivacaine
5 ml of 1% lidocaine
10000 units of thrombin
1000 mg of aminocaproic acid
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pre-Operative Pain
Time Frame: Baseline (Day of Surgery)
|
Pain rated on a scale from 0 (no pain) to 10 (highest level of pain ever experienced).
|
Baseline (Day of Surgery)
|
|
Post-Operative Pain
Time Frame: Up to Day 14 Post-Operative
|
Pain rated on a scale from 0 (no pain) to 10 (highest level of pain ever experienced).
|
Up to Day 14 Post-Operative
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Opioid Prescription Pills Used
Time Frame: Up to Day 14 Post-Operative
|
Opioid prescriptions (Norco 5/325 mg) will be given to patients post operatively.
Total number of pills taken up until post operative day 14 will be recorded by the patient.
|
Up to Day 14 Post-Operative
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: David Chiu, MD, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
- Postoperative Complications
- Pathologic Processes
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Pain, Postoperative
- Amino Acids, Peptides, and Proteins
- Proteins
- Organic Chemicals
- Biological Factors
- Acids, Acyclic
- Carboxylic Acids
- Anilides
- Amides
- Aniline Compounds
- Amines
- Acetanilides
- Hydrolases
- Enzymes
- Enzymes and Coenzymes
- Blood Proteins
- Amino Acids
- Acids, Carbocyclic
- Caproates
- Endopeptidases
- Peptide Hydrolases
- Cyclohexanecarboxylic Acids
- Serine Endopeptidases
- Serine Proteases
- Blood Coagulation Factors
- Aminocaproates
- Tranexamic Acid
- Bupivacaine
- Lidocaine
- Aminocaproic Acid
- Thrombin
Other Study ID Numbers
Other Study ID Numbers
- 24-01580
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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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