Clinical Tolerance of an Intraparotid Injection of Bupivacaine, Combined With Dexamethasone, After Parotidectomy for Benign Tumor (PAROCAINE)

September 4, 2026 updated by: Centre Hospitalier Universitaire de Nīmes

Evaluation of the Clinical Tolerance of an Intraparotid Injection of Bupivacaine, Combined With Dexamethasone, After Parotidectomy for Benign Tumor - A Single-center Prospective Cohort Study.

There has been a paradigm shift toward less invasive surgical techniques for parotidectomies, primarily to mitigate post-surgical complications. However, preserving more parotid tissue than with traditional methods can lead to an increased incidence of salivary fistulas and sialoceles after parotidectomy. The incidence of sialoceles varies considerably from 4.9% to 39%, while salivary fistula rates after parotidectomy range from 1% to 21%. Other wound complications, such as wound dehiscence, inflammation, and infection, can also occur, typically within the first month following surgery. No preventive technique has yet demonstrated clear efficacy or superiority in clinical practice.

Bupivacaine is an amino-amide commonly used for local anesthesia. With its long-acting anesthetic effects, bupivacaine blocks the autonomic pathways (parasympathetic and sympathetic), then the sensory pathways, and finally the motor pathways. By providing prolonged blockade of the parasympathetic nerve pathways that induce salivary secretion, bupivacaine injected into the parotid tissue during surgery could be a potentially effective prophylactic agent for preventing salivary fistulas after parotidectomy. Certain adjuvants can be used locally in combination with bupivacaine to prolong the duration of nerve blocks and improve postoperative pain management. Dexamethasone is the most effective adjuvant to long-acting local anesthetics. This combination is widely used in routine practice.

Due to its sustained blockade of parasympathetic nerve fibers, intraparotid bupivacaine, combined with local dexamethasone, could be an effective tool for reducing various postoperative complications, including sialoceles and salivary fistulas, after partial parotidectomy. It could also play a major role in postoperative analgesia. Although bupivacaine is commonly used in surgical practice, there are no data regarding the injection of bupivacaine combined with dexamethasone into the parotid tissue to prevent salivary complications after partial parotidectomy. Therefore, the safety of its use when injected specifically into the parotid tissue has never been evaluated.

The aim of this pilot study is to assess the tolerability of intraparotid injection of bupivacaine combined with a local injection of dexamethasone after partial parotidectomy for a benign tumor.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

10

Phase

  • Early Phase 1

Contacts and Locations

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

Study Contact

Study Locations

      • Nîmes, France, 30000
        • Recruiting
        • Centre Hospitalier de Nimes
        • Contact:
        • Principal Investigator:
          • Benjamin Lallemant

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:

  • Validated surgical indication for partial parotidectomy for parotid tumor.
  • The patient must have given their free and informed consent and signed the consent form
  • The patient must be a member or beneficiary of a health insurance plan

Exclusion Criteria:

  • The subject is in a period of exclusion determined by a previous study
  • The patient is under safeguard of justice or state guardianship
  • History of allergic reaction to amino-amide-type local anesthetics.
  • Severe neurological history (epilepsy, peripheral neuropathies).
  • High-risk cardiovascular history (severe hypertension, arrhythmias, complete or incomplete heart block, heart failure, coronary artery disease, treatment with type 2 antiarrhythmic drugs).
  • Severe liver or kidney disease (severe liver failure or severe kidney failure).
  • Acidosis, sepsis.
  • Pregnant or breastfeeding patient.
  • Patient unable to give informed consent.
  • Patient for whom it is impossible to provide informed consent.

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: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patients who undergoing partial parotidectomy
  • 20 ml of 0.5% bupivacaine (5 mg/mL), i.e., a dose of 100 mg;
  • 0.5 ml of dexamethasone (4 mg/mL), i.e., a dose of 2 mg.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Local pain post-injection
Time Frame: Day 15
0-10 visual analog scale
Day 15
Local intolerance post-injection
Time Frame: Day 15
Redness, edema, warmth, inflammation: Yes/no
Day 15
Local neurological disturbances post-injection
Time Frame: Day 15
Paresthesia, hypoesthesia: Yes/no
Day 15
Allergic reactions post-injection
Time Frame: Day 15
Rash, edema, urticaria: Yes/no
Day 15
Heart rate
Time Frame: Day 15
beats per minutes
Day 15
Blood pressure
Time Frame: Day 15
mm Hg
Day 15
Loss of consciousness
Time Frame: Day 15
Yes/no
Day 15
Seizures
Time Frame: Day 15
Yes/no
Day 15
Nausea and vomiting
Time Frame: Day 15
Yes/no
Day 15
Blood gluose level
Time Frame: Day 15
mmol/L
Day 15
Post-parotidectomy facial nerve function alteration post-injection
Time Frame: Day 15
Facial paralysis or facial nerve damage: Yes/no
Day 15
Injection site damage
Time Frame: Day 15
Hematoma or infection: Yes/no
Day 15

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative pain
Time Frame: Day 0
Measure on a 0-10 visual analog scale
Day 0
Postoperative pain
Time Frame: Day 1
Measure on a 0-10 visual analog scale
Day 1
Postoperative pain
Time Frame: Day 2
Measure on a 0-10 visual analog scale
Day 2
Postoperative pain
Time Frame: Day 4
Measure on a 0-10 visual analog scale
Day 4
Postoperative pain
Time Frame: Day 6
Measure on a 0-10 visual analog scale
Day 6
Postoperative pain
Time Frame: Day 9
Measure on a 0-10 visual analog scale
Day 9
Postoperative pain
Time Frame: Day 12
Measure on a 0-10 visual analog scale
Day 12
Postoperative pain
Time Frame: Day 15
Measure on a 0-10 visual analog scale
Day 15
Prevalence of salivary fistulas or sialomas
Time Frame: Day 15
Yes/no
Day 15
wound dehiscence
Time Frame: Day 15
yes/no
Day 15
inflammation of wound
Time Frame: Day 15
Yes/no
Day 15
infection of wound
Time Frame: Day 15
Yes/no
Day 15
Feasibility of bupivacaine/dexamethasone
Time Frame: Day 0
Successful administion of bupivacaine/dexamethasone injection: Yes/no
Day 0

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Benjamin Lallemant, Centre Hospitalier Universitaire de Nīmes

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)

May 18, 2026

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

September 4, 2026

First Submitted That Met QC Criteria

September 4, 2026

First Posted (Actual)

September 10, 2026

Study Record Updates

Last Update Posted (Actual)

September 10, 2026

Last Update Submitted That Met QC Criteria

September 4, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • LOCAL/2025/BL01
  • 2025 (U.S. NIH Grant/Contract: Faculty of Social Sciences Scientific Grant at the University of Gdańsk)
  • 2025-524358-32-00 (Other Identifier: CTIS)

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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