Rotator Cuff TearNCT03692546
Liposomal Bupivacaine for Pain Control After Rotator Cuff Repair
A study testing Liposomal bupivacaine (LB) in people with Rotator Cuff Tear and Postoperative Pain, run by Orthopaedic & Neurosurgery Specialists at 1 site in United States.
Trial summary
The use of an interscalene block (ISB) is often associated with rebound pain that could be avoided through adjunctive therapy with longer duration. Administration of a liposomal bupivacaine (LB) field block in addition to ISB would overcome this rebound pain to provide greater pain relief and reduce opiate consumption… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Rotator Cuff Tear, Postoperative Pain
- What is being tested?
- Liposomal bupivacaine (LB)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Feb 2017to 1 Sep 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- at least 18 years of age
- undergoing an arthroscopic rotator cuff repair surgery of a full thickness tear
- willing to fill out the "Pain Journal"; able to understand the informed consent process
- willing to document informed consent prior to completion of any study-related procedure
- able to read, comprehend, and complete subject-reported outcome measures in English
Who cannot join
- pregnant
- documented history of drug or alcohol abuse
- use of narcotic painkillers greater than 3 months prior to surgery
- neurologic deficit or disability involving the surgical extremity
- known allergy or intolerance to hydrocodone or oxycodone
- known allergy to amide anesthetics
- currently enrolled or planning to enroll in another clinical trial during this study that would affect the outcome of this study
- history of cognitive or mental health status that interferes with study participation
Trial locations and contacts
1 site in 1 country.
United States1 site
Orthopaedic & Neurosurgery Specialists
Greenwich, Connecticut, 06831
About this study
Official title: Liposomal Bupivacaine Reduces Opiate Consumption After Rotator Cuff Repair in a Randomized Control Trial
The use of an interscalene block (ISB) is often associated with rebound pain that could be avoided through adjunctive therapy with longer duration. Administration of a liposomal bupivacaine (LB) field block in addition to ISB would overcome this rebound pain to provide greater pain relief and reduce opiate consumption when compared to ISB alone. 50 patients were recruited and randomized into groups that either received or did not receive an intraoperative LB field block in addition to standard ISB administration. Visual Analog Scale (VAS) pain scores and narcotic consumption were recorded over the five-day postoperative period to determine the effectiveness of LB pain relief.
Read the detailed description
Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. As rotator cuff repair procedures become increasingly more common, these procedures and the narcotic prescriptions which accompany them may contribute to the rising opioid epidemic. The use of intraoperative local and regional anesthesia or field blocks, in conjunction with multimodal pharmacological strategies, is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a field block of liposomal bupivacaine (LB) in addition to an interscalene block (ISB) would provide greater pain relief and reduction in opiate consumption when compared to ISB alone.
The study enrolled 50 patients undergoing primary ARCR surgery. Patients were randomized to receiving intraoperative liposomal bupivacaine or not and provided with postoperative "Pain Journals" to document their daily pain on a visual analog scale (VAS) and to track their daily opioid consumption during the first five post-operative days.
- Conditions
- Rotator Cuff Tear, Postoperative Pain
- Being tested
- Liposomal bupivacaine (LB)
- Medical subject headings
- Rotator Cuff Injuries, Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Liposomal bupivacaine (LB)Drug
Also called EXPAREL
Addition of LB solution to soft tissue surgical field block to a standard interscalene block procedure
| Study group | Role | What they receive |
|---|---|---|
| Liposomal Bupivacaine (LB) | Experimental | Administration of 20 ml of LB diluted with an additional 40 ml of saline was injected into a triangular soft tissue surgical field block, along with standard bupivacaine interscalene block Receives: Drug: Liposomal bupivacaine (LB) |
| Interscalene Block Alone (ISB) | No intervention | Administration of 20mL of 0.5% standard bupivacaine interscalene block with no additional soft tissue surgical field block |
What is being measured
The primary outcome is the main question the study is designed to answer.
Daily Opioid Consumption in Oral Morphine Equivalent
Total amount of narcotics consumed over the study period following surgery
Measured: Post-operative day one to five
Secondary outcomes (1)
Visual Analog Scale Pain Scores
A standardized measure of subjective pain on a scale of 0 to 10, from zero pain to excruciating pain, respectively
Measured: Post-operative day one to five
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Oct 2018
- Study start1 Feb 2017
- Primary completion1 Mar 2018
- Study completion1 Sep 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (26)Papers the sponsor has linked to this study.
- Other trials for Rotator Cuff TearStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 50 participants (actual)
Sponsor and investigators
- Lead sponsor
- Orthopaedic & Neurosurgery Specialists
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Paul Sethi, Orthopaedic & Neurosurgery Specialists
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03692546
- Sponsor's protocol ID
- 2016017
- Status last verified
- Sep 2018
- First submitted
- 26 Sep 2018
- Last updated
- 2 Oct 2018
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Barber FA. Suprascapular nerve block for shoulder arthroscopy. Arthroscopy. 2005 Aug;21(8):1015. doi: 10.1016/j.arthro.2005.05.033.
PubMed 16086570Boddu C, Genza A, McCann PD. Bridging multimodal pain management provides 48-hour pain control in patients undergoing total shoulder replacement. J Shoulder Elbow Surg. 2018 Jun;27(6S):S65-S69. doi: 10.1016/j.jse.2017.12.026. Epub 2018 Feb 13.
PubMed 29426743Boss AP, Maurer T, Seiler S, Aeschbach A, Hintermann B, Strebel S. Continuous subacromial bupivacaine infusion for postoperative analgesia after open acromioplasty and rotator cuff repair: preliminary results. J Shoulder Elbow Surg. 2004 Nov-Dec;13(6):630-4. doi: 10.1016/j.jse.2004.04.005.
PubMed 15570231Bramlett K, Onel E, Viscusi ER, Jones K. A randomized, double-blind, dose-ranging study comparing wound infiltration of DepoFoam bupivacaine, an extended-release liposomal bupivacaine, to bupivacaine HCl for postsurgical analgesia in total knee arthroplasty. Knee. 2012 Oct;19(5):530-6. doi: 10.1016/j.knee.2011.12.004. Epub 2012 Jan 28.
PubMed 22285545Chan CW, Peng PW. Suprascapular nerve block: a narrative review. Reg Anesth Pain Med. 2011 Jul-Aug;36(4):358-73. doi: 10.1097/AAP.0b013e3182204ec0.
PubMed 21654552Chang KV, Wu WT, Hung CY, Han DS, Yang RS, Chang CH, Lin CP. Comparative Effectiveness of Suprascapular Nerve Block in the Relief of Acute Post-Operative Shoulder Pain: A Systematic Review and Meta-analysis. Pain Physician. 2016 Sep-Oct;19(7):445-56.
PubMed 27676661Ensor KL, Kwon YW, Dibeneditto MR, Zuckerman JD, Rokito AS. The rising incidence of rotator cuff repairs. J Shoulder Elbow Surg. 2013 Dec;22(12):1628-32. doi: 10.1016/j.jse.2013.01.006. Epub 2013 Mar 1.
PubMed 23466172Jacob BC, Peasah SK, Shogbon AO, Perlow ER. Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital. Hosp Pharm. 2017 May;52(5):367-373. doi: 10.1177/0018578717715382. Epub 2017 May 1.
PubMed 28804154Kaye AD, Jones MR, Kaye AM, Ripoll JG, Galan V, Beakley BD, Calixto F, Bolden JL, Urman RD, Manchikanti L. Prescription Opioid Abuse in Chronic Pain: An Updated Review of Opioid Abuse Predictors and Strategies to Curb Opioid Abuse: Part 1. Pain Physician. 2017 Feb;20(2S):S93-S109.
PubMed 28226333Kumar K, Gulotta LV, Dines JS, Allen AA, Cheng J, Fields KG, YaDeau JT, Wu CL. Unused Opioid Pills After Outpatient Shoulder Surgeries Given Current Perioperative Prescribing Habits. Am J Sports Med. 2017 Mar;45(3):636-641. doi: 10.1177/0363546517693665. Epub 2017 Feb 9.
PubMed 28182507McLaughlin DC, Cheah JW, Aleshi P, Zhang AL, Ma CB, Feeley BT. Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study. J Shoulder Elbow Surg. 2018 Apr;27(4):686-691. doi: 10.1016/j.jse.2017.11.015. Epub 2018 Jan 3.
PubMed 29305103Morris BJ, Mir HR. The opioid epidemic: impact on orthopaedic surgery. J Am Acad Orthop Surg. 2015 May;23(5):267-71. doi: 10.5435/JAAOS-D-14-00163.
PubMed 25911660Routman HD, Israel LR, Moor MA, Boltuch AD. Local injection of liposomal bupivacaine combined with intravenous dexamethasone reduces postoperative pain and hospital stay after shoulder arthroplasty. J Shoulder Elbow Surg. 2017 Apr;26(4):641-647. doi: 10.1016/j.jse.2016.09.033. Epub 2016 Nov 15.
PubMed 27856266Sabesan VJ, Shahriar R, Petersen-Fitts GR, Whaley JD, Bou-Akl T, Sweet M, Milia M. A prospective randomized controlled trial to identify the optimal postoperative pain management in shoulder arthroplasty: liposomal bupivacaine versus continuous interscalene catheter. J Shoulder Elbow Surg. 2017 Oct;26(10):1810-1817. doi: 10.1016/j.jse.2017.06.044. Epub 2017 Aug 24.
PubMed 28844420Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use - United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2017 Mar 17;66(10):265-269. doi: 10.15585/mmwr.mm6610a1.
PubMed 28301454
Study at a glance
From the registry record, last updated by the sponsor on 2 Oct 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Liposomal Bupivacaine Reduces Opiate Consumption After Rotator Cuff Repair in a Randomized Control Trial
- ClinicalTrials.gov ID
- NCT03692546
- Acronym / sponsor ID
- 2016017
- Conditions
- Rotator Cuff Tear, Postoperative Pain
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 50 participants (actual)
- Lead sponsor
- Orthopaedic & Neurosurgery SpecialistsUniversity, hospital or other
- Study start
- 1 Feb 2017 (actual)
- Primary completion
- 1 Mar 2018 (actual)
- Study completion
- 1 Sep 2018 (actual)
- First posted
- 2 Oct 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The use of an interscalene block (ISB) is often associated with rebound pain that could be avoided through adjunctive therapy with longer duration. Administration of a liposomal bupivacaine (LB) field block in addition to ISB would overcome this rebound pain to provide greater pain relief and reduce opiate consumption when compared to ISB alone. 50 patients were recruited and randomized into groups that either received or did not receive an intraoperative LB field block in addition to standard ISB administration. Visual Analog Scale (VAS) pain scores and narcotic consumption were recorded over the five-day postoperative period to determine the effectiveness of LB pain relief.
Detailed description
Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. As rotator cuff repair procedures become increasingly more common, these procedures and the narcotic prescriptions which accompany them may contribute to the rising opioid epidemic. The use of intraoperative local and regional anesthesia or field blocks, in conjunction with multimodal pharmacological strategies, is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a field block of liposomal bupivacaine (LB) in addition to an interscalene block (ISB) would provide greater pain relief and reduction in opiate consumption when compared to ISB alone.
The study enrolled 50 patients undergoing primary ARCR surgery. Patients were randomized to receiving intraoperative liposomal bupivacaine or not and provided with postoperative "Pain Journals" to document their daily pain on a visual analog scale (VAS) and to track their daily opioid consumption during the first five post-operative days.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Liposomal Bupivacaine (LB) | Experimental | Drug: Liposomal bupivacaine (LB)Administration of 20 ml of LB diluted with an additional 40 ml of saline was injected into a triangular soft tissue surgical field block, along with standard bupivacaine interscalene block |
| Interscalene Block Alone (ISB) | No intervention | –Administration of 20mL of 0.5% standard bupivacaine interscalene block with no additional soft tissue surgical field block |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- at least 18 years of age
- undergoing an arthroscopic rotator cuff repair surgery of a full thickness tear
- willing to fill out the "Pain Journal"; able to understand the informed consent process
- willing to document informed consent prior to completion of any study-related procedure
- able to read, comprehend, and complete subject-reported outcome measures in English
Key exclusion criteria (8 listed)
- pregnant
- documented history of drug or alcohol abuse
- use of narcotic painkillers greater than 3 months prior to surgery
- neurologic deficit or disability involving the surgical extremity
- known allergy or intolerance to hydrocodone or oxycodone
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Liposomal bupivacaine (LB)Also: EXPARELAddition of LB solution to soft tissue surgical field block to a standard interscalene block procedure | Drug | Liposomal Bupivacaine (LB) |
Primary outcome
Daily Opioid Consumption in Oral Morphine Equivalent
Time frame: Post-operative day one to five
Total amount of narcotics consumed over the study period following surgery
1 secondary outcome
Visual Analog Scale Pain Scores
Time frame: Post-operative day one to five
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Oct 2018.
- Background: PubMed 16086570Barber FA. Suprascapular nerve block for shoulder arthroscopy. Arthroscopy. 2005 Aug;21(8):1015. doi: 10.1016/j.arthro.2005.05.033.
- Background: PubMed 29426743Boddu C, Genza A, McCann PD. Bridging multimodal pain management provides 48-hour pain control in patients undergoing total shoulder replacement. J Shoulder Elbow Surg. 2018 Jun;27(6S):S65-S69. doi: 10.1016/j.jse.2017.12.026. Epub 2018 Feb 13.
- Background: PubMed 15570231Boss AP, Maurer T, Seiler S, Aeschbach A, Hintermann B, Strebel S. Continuous subacromial bupivacaine infusion for postoperative analgesia after open acromioplasty and rotator cuff repair: preliminary results. J Shoulder Elbow Surg. 2004 Nov-Dec;13(6):630-4. doi: 10.1016/j.jse.2004.04.005.
- Background: PubMed 22285545Bramlett K, Onel E, Viscusi ER, Jones K. A randomized, double-blind, dose-ranging study comparing wound infiltration of DepoFoam bupivacaine, an extended-release liposomal bupivacaine, to bupivacaine HCl for postsurgical analgesia in total knee arthroplasty. Knee. 2012 Oct;19(5):530-6. doi: 10.1016/j.knee.2011.12.004. Epub 2012 Jan 28.
- Background: PubMed 21654552Chan CW, Peng PW. Suprascapular nerve block: a narrative review. Reg Anesth Pain Med. 2011 Jul-Aug;36(4):358-73. doi: 10.1097/AAP.0b013e3182204ec0.
- Background: PubMed 27676661Chang KV, Wu WT, Hung CY, Han DS, Yang RS, Chang CH, Lin CP. Comparative Effectiveness of Suprascapular Nerve Block in the Relief of Acute Post-Operative Shoulder Pain: A Systematic Review and Meta-analysis. Pain Physician. 2016 Sep-Oct;19(7):445-56.
- Background: PubMed 23466172Ensor KL, Kwon YW, Dibeneditto MR, Zuckerman JD, Rokito AS. The rising incidence of rotator cuff repairs. J Shoulder Elbow Surg. 2013 Dec;22(12):1628-32. doi: 10.1016/j.jse.2013.01.006. Epub 2013 Mar 1.
- Background: PubMed 28804154Jacob BC, Peasah SK, Shogbon AO, Perlow ER. Postoperative Pain Management With Liposomal Bupivacaine in Patients Undergoing Orthopedic Knee and Hip Arthroplasty at a Community Hospital. Hosp Pharm. 2017 May;52(5):367-373. doi: 10.1177/0018578717715382. Epub 2017 May 1.
- Background: PubMed 28226333Kaye AD, Jones MR, Kaye AM, Ripoll JG, Galan V, Beakley BD, Calixto F, Bolden JL, Urman RD, Manchikanti L. Prescription Opioid Abuse in Chronic Pain: An Updated Review of Opioid Abuse Predictors and Strategies to Curb Opioid Abuse: Part 1. Pain Physician. 2017 Feb;20(2S):S93-S109.
- Background: PubMed 28182507Kumar K, Gulotta LV, Dines JS, Allen AA, Cheng J, Fields KG, YaDeau JT, Wu CL. Unused Opioid Pills After Outpatient Shoulder Surgeries Given Current Perioperative Prescribing Habits. Am J Sports Med. 2017 Mar;45(3):636-641. doi: 10.1177/0363546517693665. Epub 2017 Feb 9.
- Background: PubMed 29305103McLaughlin DC, Cheah JW, Aleshi P, Zhang AL, Ma CB, Feeley BT. Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study. J Shoulder Elbow Surg. 2018 Apr;27(4):686-691. doi: 10.1016/j.jse.2017.11.015. Epub 2018 Jan 3.
- Background: PubMed 25911660Morris BJ, Mir HR. The opioid epidemic: impact on orthopaedic surgery. J Am Acad Orthop Surg. 2015 May;23(5):267-71. doi: 10.5435/JAAOS-D-14-00163.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Liposomal bupivacaine (LB) in people with Rotator Cuff Tear and Postoperative Pain, run by Orthopaedic & Neurosurgery Specialists at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 2 Oct 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Daily Opioid Consumption in Oral Morphine Equivalent (time frame: Post-operative day one to five). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03692546, which also lists 26 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2018.