Effect of Optimal Biological Volume Bupivacaine Liposome Interscalene Brachial Plexus Block on Postoperative Analgesia After Shoulder Arthroscopy

August 27, 2026 updated by: Qing-he Zhou, Affiliated Hospital of Jiaxing University
This study aims to evaluate whether 15ml/75mg low-dose bupivacaine liposome is non-inferior to 15ml/133mg standard-dose bupivacaine liposome for postoperative analgesia in interscalene brachial plexus block during arthroscopic shoulder surgery, through a single-center, prospective, double-blind, non-inferiority randomized controlled clinical trial. It will also assess whether 15ml/75mg low-dose bupivacaine liposome is superior to 15ml/133mg standard-dose bupivacaine liposome in terms of diaphragmatic excursion, pulmonary function, duration of block effect, and nerve block-related adverse reactions during interscalene brachial plexus block.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

This study is designed as a single-center, prospective, double-blind, non-inferiority randomized controlled clinical trial, to evaluate and compare whether the postoperative analgesic efficacy of 15 mL/75 mg low-dose liposomal bupivacaine for interscalene brachial plexus block in patients undergoing shoulder arthroscopy is non-inferior to that of 15 mL/133 mg standard-dose liposomal bupivacaine, and to further assess whether the low-dose regimen demonstrates advantages over the standard-dose counterpart in terms of diaphragmatic excursion, pulmonary function, duration of block effect, and nerve block-related adverse reactions.

Study Type

Interventional

Enrollment (Estimated)

40

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

    • Zhejiang
      • Jiaxing, Zhejiang, China, 314000
        • Jiaxing University Affiliated Hospital

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients aged 18 years or older.
  • ASA classification I-III.
  • Arthroscopic shoulder rotator cuff repair, capsular plication, acromioplasty, synovectomy, etc.

Exclusion Criteria:

  • Have a history of lung disease.
  • Coagulation dysfunction or coagulopathy.
  • History of allergy to local anesthetics.
  • infection or lesions at the block site; or history of cervical spine disease.
  • pregnancy.
  • Refusal to participate in the study or inability to communicate.
  • Long-term use of opioids.
  • Body mass index >35 kg/m2
  • Previous history of nerve injury, paralysis, or paresis;

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: OBV bupivacaine liposome group
Following our preliminary study protocol, 13 mL of liposomal bupivacaine (derived from the 20 mL/266 mg commercial formulation) is aspirated and further diluted with 0.9% sodium chloride injection to a final total volume of 53 mL while maintaining the fixed total dose of 266 mg. This diluted preparation is then combined with 2 mL of 0.5% conventional bupivacaine, and the resultant 55 mL mixture is administered to perform interscalene brachial plexus block prior to surgical incision.
Following our preliminary study protocol, 13 mL of liposomal bupivacaine (derived from the 20 mL/266 mg commercial formulation) is aspirated and further diluted with 0.9% sodium chloride injection to a final total volume of 53 mL while maintaining the fixed total dose of 266 mg. This diluted preparation is then combined with 2 mL of 0.5% conventional bupivacaine, and the resultant 55 mL mixture is administered to perform interscalene brachial plexus block prior to surgical incision.
Experimental: Standard dose bupivacaine liposome group
Following the recommendations in published literature and the approved product labeling, 10 mL of liposomal bupivacaine (20 mL/266 mg formulation) is aspirated, combined with 2 mL of 0.5% conventional bupivacaine, diluted to a final total volume of 15 mL with 0.9% sodium chloride injection, and administered to perform ultrasound-guided interscalene brachial plexus block prior to surgical incision.
Following the recommendations in published literature and the approved product labeling, 10 mL of liposomal bupivacaine (20 mL/266 mg formulation) is aspirated, combined with 2 mL of 0.5% conventional bupivacaine, diluted to a final total volume of 15 mL with 0.9% sodium chloride injection, and administered to perform ultrasound-guided interscalene

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Difference in numeric rating scale scores for resting pain at 24 hours after surgery
Time Frame: postoperative 24 hours
Difference in numeric rating scale scores(0 = no pain, 10 = worst pain; higher numbers indicate greater pain intensity) for resting pain at 24 hours after surgery. Postoperatively, the NRS scale was used to evaluate pain scores.
postoperative 24 hours

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total consumption of morphine milligram equivalents within 72 hours postoperatively
Time Frame: within 72 hours postoperatively
Record opioid analgesics within 72 hours postoperatively, convert to morphine equivalent dose, and calculate the total amount.
within 72 hours postoperatively
Differences in numeric rating scale pain scores at rest and during activity within 0.5 hours, 6 hours, 24 hours, 48 hours, and 72 hours postoperatively
Time Frame: postoperative 0.5 hours, 6 hours, 24 hours, 48 hours, 72 hours
Differences in numeric rating scale (0 = no pain, 10 = worst pain; higher numbers indicate greater pain intensity) pain scores at rest and during activity within 0.5 hours, 6 hours, 24 hours, 48 hours, and 72 hours postoperatively. Postoperatively, the NRS scoring scale was used to assess pain scores.
postoperative 0.5 hours, 6 hours, 24 hours, 48 hours, 72 hours
Complete unilateral HDP during quiet breathing at 0.5 hours 6 hours, and 24 hours after completion of block
Time Frame: postoperative 0.5 hours, 6 hours and 24 hours
A diaphragm excursion of >75% on the blocked side measured under ultrasound is defined as complete unilateral hemidiaphragmatic paralysis (HDP).
postoperative 0.5 hours, 6 hours and 24 hours
Pulmonary function
Time Frame: postoperative 0.5 hours, 6 hours and 24 hours
Use a portable respiratory function tester for bedside testing; have the patient blow three times and take the average.
postoperative 0.5 hours, 6 hours and 24 hours
All adverse events related to surgery and anesthesia occurring within 72 hours postoperatively
Time Frame: within 72 hours postoperatively
Adverse events associated with nerve blocks within 72 hours postoperatively, including pneumothorax, intravascular injection, local anesthetic toxicity, and Horner syndrome, were recorded.
within 72 hours postoperatively
The number of rescue analgesic interventions required within 72 hours postoperatively
Time Frame: within 72 hours postoperatively
The number of analgesic administrations within the first 72 hours postoperatively was recorded.
within 72 hours postoperatively
sensorimotor score
Time Frame: postoperative 0.5 hours, 6 hours and 24 hours
After completion of the block, the simplified sensorimotor assessment scale (3-point method) is used for evaluation, and a total sensorimotor score ≥12 points with a total sensory score ≥3 points is defined as successful brachial plexus block.
postoperative 0.5 hours, 6 hours and 24 hours

Collaborators and Investigators

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

Sponsor

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 (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 1, 2028

Study Completion (Estimated)

September 1, 2028

Study Registration Dates

First Submitted

August 23, 2026

First Submitted That Met QC Criteria

August 27, 2026

First Posted (Actual)

August 28, 2026

Study Record Updates

Last Update Posted (Actual)

August 28, 2026

Last Update Submitted That Met QC Criteria

August 27, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2026-LP-402

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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