- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01314144
Use of Continuous Wound Infusion of Bupivacaine for Analgesia Following Axillary Clearance Surgery
Does Continuous Wound Infusion of 0.2% Bupivacaine Provide Superior Analgesia Compared to Standard Opioid-based Therapy in Patients Following Axillary Clearance Surgery?
Axillary clearance forms part of the surgical armamentarium for the treatment of breast cancer. Although the introduction of sentinel lymph node mapping and dissection has allowed for the decreased use of axillary clearance, it remains a frequently performed operation. Axillary clearance is associated with moderate postoperative pain.
We hypothesize that a continuous wound infusion of 0.2% Bupivacaine at 4ml/hr would provide superior analgesia, when compared to standard opioid-based analgesia, in patients undergoing axillary lymph node clearance surgery.
Study Overview
Detailed Description
The study will take the form of a prospective randomised clinical trial. The following assessment tools will be used
- The visual analogue scale (VAS) consists of a 100 mm horizontal line with the two end points labelled "no pain" and "worst pain ever". Patients are asked to mark on the line a point that corresponds to the level of pain intensity they feel. The score is obtained by measuring the distance (mm) from the left end of the line.
- The short-form McGill Pain Questionnaire (SF-MPQ) consists of 15 representative words from the sensory and affective categories of the standard McGill Pain Questionnaire. It also includes the present pain intensity and a VAS to provide overall indices of pain intensity. It has been shown to be sensitive to clinical changes brought about by various interventions, postoperative analgesic drugs (6).
- The Pain Catastrophising Score (PCS) is a 13 item instrument which asks patient to reflect on past painful experiences, and to indicate the degree to which they experienced each of these 13 thoughts or feelings, on 5-point scales with the end points; 0 = not at all, 4 = all the time. The PCS yields a total score and three subscale scores assessing rumination, magnification and helplessness (7).
- The Hospital Anxiety and Depression Score (HADS) is a 14-item scale, which screens for these, the two most common disturbances encountered in a medical setting (8).
Study Type
Enrollment (Anticipated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Denise M McCarthy, MB FCARCSI
- Phone Number: 353 87 2341254
- Email: dmc_btown@yahoo.co.uk
Study Contact Backup
- Name: Brian O'Donnell, MD FCARCSI
- Phone Number: 353 21 4922135
- Email: briodnl@gmail.com
Study Locations
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-
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Cork, Ireland
- Recruiting
- Cork Universtiy Hospital
-
Principal Investigator:
- Denise M McCarthy, MB FCARCSI
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients undergoing axillary clearance surgery
- ASA physical status I - III
Exclusion Criteria:
- Patient refusal
- Pre-existing pain conditions
- Regular use of opioid analgesia
- Pregnancy
- Severe cardiac, renal or hepatic disease
- Psychiatric illness precluding ability to give informed consent
- Intercurrent neurological disease
- Contraindications to bupivacaine or morphine use
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Bupivacaine
Patients will receive intraoperative wound soakage with 20ml of 0.5% bupivacaine with adrenaline by the surgeon before closure and receive a continuous infusion of 4ml/hr of 0.2% bupivacaine delivered by an elastomeric pump the catheter of which will be placed by the surgeon in the wound before closure.
Postoperative anlagesia will be provided with oxycodone, paracetamol and diclofenac.
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intraoperative wound soakage with 20ml of 0.5% bupivacaine with epinephrine and continuous infusion of 4ml/hr of 0.2% bupivacaine for 48 hours postoperatively
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No Intervention: Control
Patients will receive morphine up to 0.1mg/kg intraoperatively.
Postoperative analgesia will be provided with oxycodone, paracetamol and diclofenac.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Pain on abducting the arm on the operative side to 90 degrees as measured using a 100mm visual analogue scale at 6 hours following surgery.
Time Frame: 6 hours postoperatively
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6 hours postoperatively
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Pain (at rest and on movement) in the recovery room and at 6, 24 and 48 hours after surgery.
Time Frame: 48 hours postoperatively
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48 hours postoperatively
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Cumulative Oxycodone consumption at 6, 24 and 48 hours after surgery
Time Frame: 48 hours postoperatively
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48 hours postoperatively
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incidence of nausea and vomiting
Time Frame: 48 hours postoperatively
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48 hours postoperatively
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Denise M McCarthy, MB FCARCSI, Cork Universtiy Hospital
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- AC-CUH
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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