- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03663283
Liposomal Bupivacaine Interscalene Nerve Block in Shoulder Arthroplasty
February 15, 2021 updated by: Steven J. Hattrup, MD, Mayo Clinic
Liposomal Bupivacaine Interscalene Nerve Block in Shoulder Arthroplasty: A Single Blinded Prospective Randomized Control Trial
The objective of this study is to determine if peripheral nerve block with liposomal bupivacaine in combination with standard bupivacaine will prolong the duration of block, improve pain scores, and decrease opioid utilization in the post-operative period when compared to peripheral nerve block with standard bupivacaine alone.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This is a prospective, single-blinded randomized clinical trial comparing outcomes in patients undergoing total shoulder arthroplasty (anatomic and reverse) who receive a peripheral nerve block with liposomal bupivacaine in combination with standard bupivacaine versus standard bupivacaine alone.
Once consent is obtained, baseline characteristics will be recorded and patients will be randomized to intervention or control.
Following surgery, patients will be followed until their 3-week post-operative visit.
The primary outcome measure will be the mean difference in patient pain scores over the first 72 hours post-operatively between two groups.
Secondary outcomes will include: (1) Total opioid consumption (as measured utilizing morphine intravenous equivalents) in first 72 hours and at 3 weeks (2) Patient perceived duration of block determined as the time patient perceives complete resolution of block (3) Patient satisfaction with pain control at 72 hours, 3 weeks post-operatively and patient reported outcome measures (SANE, SST, ASES, VR-12) at 3 weeks post-operatively.
Study Type
Interventional
Enrollment (Actual)
104
Phase
- Phase 4
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
-
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Arizona
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Phoenix, Arizona, United States, 85054
- Mayo Clinic in Arizona
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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
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria
- All adult patients (>18 years of age)
- Patients undergoing standard or reverse total shoulder arthroplasty for the primary diagnoses of glenohumeral arthritis or cuff tear arthropathy
- Cognitively intact with the ability to give informed consent as outlined by our institutional review board.
- Patients must be capable of participating in the post-operative electronic survey and / or able to maintain a written diary of events
Exclusion Criteria
- Non-elective cases
- Infection, tumor, trauma
- Weight < 50 kg
- Patients with any contraindications to regional anesthesia including allergy or hypersensitivity to amide-type local anesthetics
- Patients with allergy to any component of medication regimen e.g. amide- type local anesthetics, oxycodone, hydromorphone, fentanyl
- Chronic pain patients with history of chronic opioid use (defined as 20 mg morphine equivalent / day for greater than 30 days pre-operatively
- Concurrent painful physical condition that may require analgesic treatment that is not related to the shoulder surgery (chronic peripheral neuropathy, radiculopathy, or other neurologic disorder)
- Severe hepatic disease defined by clinical evidence of liver disease with abnormal liver function tests.
- Pregnancy
- Respiratory disease that contraindicates interscalene nerve block (elevated contralateral hemidiaphragm, contralateral pneumonectomy, or severe COPD with FEV1 < 50% predicted, and 02 dependence)
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: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Liposomal Bupivacaine
Administered utilizing ultrasound guidance by an anesthesiologist.
Study patients will receive 10ml (133 mg) of liposomal bupivacaine mixed with 7.5ml of 0.5% plain bupivacaine and 7.5ml of 0.25% bupivacaine.
Further, 8 mg (2 ml) IV dexamethasone will be administered concomitantly at the time of the block.
|
Interscalene Nerve Blocks
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Active Comparator: Plain Bupivacaine
Peripheral nerve blocks will be performed with ultrasound guidance by an anesthesiologist.
Standard bupivacaine hydrochloride will be utilized.
25 ml of 0.5% bupivacaine for peripheral nerve block will be utilized.
Further, 8 mg (2 ml) IV dexamethasone will be administered concomitantly at the time of the block.
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Interscalene Nerve Blocks
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient Pain Scores
Time Frame: 72 hours post-operatively
|
Patient pain scores over the first 72 hours post-operatively as measured by the Visual Analogue Scale where Zero represents no pain and ten represents severe pain.
|
72 hours post-operatively
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Opioid Consumption
Time Frame: Measured at 72 hours and at 3 weeks post-operatively
|
Total opioid consumption as measured by morphine milligram equivalent (MME) in first 72 hours and at 3 weeks
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Measured at 72 hours and at 3 weeks post-operatively
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Time to Cessation of Nerve Blockade
Time Frame: 4, 8, 12, 16, 20, 24, and 28 hours post-operatively
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Measured by the number of subjects who reported cessation of nerve blockade as the first reported postoperative pain score of 3 or greater at the surgical site.
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4, 8, 12, 16, 20, 24, and 28 hours post-operatively
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Satisfaction With Pain Control Using Satisfaction Scale
Time Frame: Measured at 72 hours and at three weeks post-operatively
|
Patient satisfaction with pain control at 72 hours post-operatively and three weeks post operatively using Patient Satisfaction with Pain Management Pain Scale where Zero represents unsatisfactory pain management and ten represents perfect pain management.
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Measured at 72 hours and at three weeks post-operatively
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Steven J Hattrup, Mayo Clinic
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Helpful Links
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)
October 29, 2018
Primary Completion (Actual)
February 14, 2020
Study Completion (Actual)
February 14, 2020
Study Registration Dates
First Submitted
September 4, 2018
First Submitted That Met QC Criteria
September 6, 2018
First Posted (Actual)
September 10, 2018
Study Record Updates
Last Update Posted (Actual)
February 21, 2021
Last Update Submitted That Met QC Criteria
February 15, 2021
Last Verified
February 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 18-005366
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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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