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Pain, PostoperativePhase 4NCT04278846

Efficacy of Liposomal Bupivacaine for Prolonged Postoperative Analgesia in Patient Undergoing Breast Reconstruction With Tissue Expander

A Phase 4 study testing Depofoam bupivacaine and Bupivacaine hydrochloride (HCl) in people with Pain, Postoperative and Mammaplasty, run by The Cleveland Clinic at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Patients undergoing breast reconstruction with tissue expanders will be treated with a local anesthetic during their procedure and monitor their post-operative pain level and amount of oral pain medication taken. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Pain, Postoperative, Mammaplasty
What is being tested?
Depofoam bupivacaine and Bupivacaine hydrochloride (HCl)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteUnited States
Study dates
22 Aug 2014to 15 May 2019
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

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
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • undergoing breast reconstruction with tissue expander

Who cannot join

  • history of adverse reaction to local anesthesia
  • chronic liver disease
  • history of chronic preoperative consumption of narcotics or opioids
  • history of alcohol and/or illicit drug dependence
  • undergoing combined procedures
  • diagnosed with neuromuscular/neurosensory disorder
Show all 11Show fewer
  • positive pregnancy test
  • previous breast conservation therapy (lumpectomy with radiation treatment
  • previous surgeries or trauma in the breast or chest region (denervation may bias pain perception)
  • axillary node dissection
  • psychosis.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Cleveland Clinic

    Cleveland, Ohio, 44195

Other trials in United States

About this study

Patients undergoing breast reconstruction with tissue expanders will be treated with a local anesthetic during their procedure and monitor their post-operative pain level and amount of oral pain medication taken. This information will be used to determine if liposomal bupivacaine provides better and longer pain control vs. bupivacaine HCl.

Read the detailed description

Fifty consecutive (25 per arm) patients undergoing unilateral or bilateral breast reconstruction with tissue expanders will be administered intraoperatively in a standardized manner with either bupivicaine HCl (control group) or liposomal bupivacaine/Exparel (experimental group). Pain will be assessed qualitatively through the use of: 1) numeric rating scale during rest (NRS-R) and activity (NRS-A), 2) brief pain inventory (BPI) questionnaire, and 3) postoperative analgesia patient satisfaction scale. Furthermore, investigators will record the use of rescue analgesics for each patient. This part of the study will provide quantitative data that investigators can then use in comparison to the qualitative measurements (NSR, BPI, patient satisfaction scale rate). In turn, this will allow us to objectify patient's pain, thereby increasing the validity of our results. More importantly, this aspect of the investigation will enable us to study the impact that liposomal bupivacaine has in reducing the postoperative usage of opioid medications in this patient population. As this is a pilot study, a sample size of 50 total patients (25 per treatment group) is planned. This sample size should provide estimates of potential effect sizes and variability in the present setting to allow for future study planning. This study should provide adequate evidence of whether pain decreases of 15% or more are unlikely in this setting.

Investigators aim to evaluate the effectiveness of DepoFoam Bupivicaine (Exparel®) to reduce postoperative pain in breast reconstruction patients compared to the current standard treatment (bupivacaine HCl). Investigators hypothesize that patients undergoing breast reconstruction with tissue expander will achieve greater control of post-operative pain and longer lasting analgesia with the use of liposomal bupivacaine.

Being tested
Depofoam bupivacaine, Bupivacaine hydrochloride (HCl)
Medical subject headings
Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Depofoam bupivacaineDrug

    Also called liposomal bupivacaine, Exparel

    The study drug Depofoam bupivacaine will be administered into the right and/or left breast of each patient 30 minutes prior to the creation of the subpectoral muscle pocket.

  • Bupivacaine hydrochloride (HCl)Drug

    Also called Marcaine

    The study drug bupivacaine HCl will be administered into the right and/or left breast of each patient 30 minutes prior to the creation of the subpectoral muscle pocket.

Study groups in NCT04278846
Study groupRoleWhat they receive
DepoFoam bupivacaineExperimentallocal anesthetic
Receives: Drug: Depofoam bupivacaine
Bupivacaine hydrochloride (HCl)Active comparatorlocal anesthetic
Receives: Drug: Bupivacaine hydrochloride (HCl)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. 1 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during rest (NRS-R) Scale name: Numeric rating scale during rest (NRS-R) The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain)

    Measured: 1 hour post-operatively

  2. 8-12 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during rest (NRS-R) The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain)

    Measured: 8-12 hours post-operatively

  3. 24 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain)

    Measured: 24 hours post-operatively

  4. 36 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain)

    Measured: 36 hours post-operatively

  5. 48 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 48 hours post-operatively

  6. 60 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 60 hours post-operatively

  7. 72 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 72 hours post-operatively

  8. 84 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 84 hours post-operatively

  9. 96 Hour Pain Assessment Numeric Rating Scale During Rest

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during rest (NRS-R).

    The higher scores indicate more severe pain during rest (10 meaning the worst pain, 0 meaning no pain) Range 0-10

    Measured: 96 hours post-operatively

  10. 36 Hour Pain Assessment Numeric Rating Scale During Activity

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during activity (NRS-A).

    The higher scores indicate more severe pain during activity (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 36 hours post-operatively

  11. 48 Hour Pain Assessment Numeric Rating Scale During Activity

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during activity (NRS-A).

    The higher scores indicate more severe pain during activity (10 meaning the worst pain,0 meaning no pain) The range is 0 to 10.

    Measured: 48 hours post-operatively

  12. 60 Hour Pain Assessment Numeric Rating Scale During Activity

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during activity (NRS-A).

    The higher scores indicate more severe pain during activity (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 60 hours post-operatively

  13. 72 Hour Pain Assessment Numeric Rating Scale During Activity

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during activity (NRS-A).

    The higher scores indicate more severe pain during activity (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 72 hours post-operatively

  14. 84 Hour Pain Assessment Numeric Rating Scale During Activity

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during activity (NRS-A).

    The higher scores indicate more severe pain during activity (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 84 hours post-operatively

  15. 96 Hour Pain Assessment Numeric Rating Scale During Activity

    Pain will be assessed qualitatively through the use of numeric rating scale (0-10) during activity (NRS-A).

    The higher scores indicate more severe pain during activity (10 meaning the worst pain, 0 meaning no pain) The range is 0 to 10.

    Measured: 96 hours post-operatively

  16. 24 Hour Pain Assessment Brief Pain Inventory

    Pain will be assessed qualitatively through the use of the Brief Pain Inventory (BPI) Questionnaire This is also a validated scale from 0 to 10, with 10 having the most severe pain and 0 being no pain

    Measured: 24 hours post-operatively

  17. 48 Hour Pain Assessment Brief Pain Inventory

    Pain will be assessed qualitatively through the use of the Brief Pain Inventory (BPI) Questionnaire This is also a validated scale from 0 to 10, with 10 having the most severe pain and 0 being no pain

    Measured: 48 hours post-operatively

  18. 72 Hour Pain Assessment Brief Pain Inventory

    Pain will be assessed qualitatively through the use of the Brief Pain Inventory (BPI) Questionnaire This is also a validated scale from 0 to 10, with 10 having the most severe pain and 0 being no pain

    Measured: 72 hours post-operatively

  19. 96 Hour Pain Assessment Brief Pain Inventory

    Pain will be assessed qualitatively through the use of the Brief Pain Inventory (BPI) Questionnaire This is also a validated scale from 0 to 10, with 10 having the most severe pain and 0 being no pain

    Measured: 96 hours post-operatively

  20. 96 Hour Pain Assessment Post-Operative Analgesia Patient Satisfaction

    Pain will be assessed qualitatively through the use of post-operative analgesia patient satisfaction scale (0-5) The higher scores indicate more satisfied patients.( 5 would be very satisfied-less pain, 0 would indicate unsatisfied patients-more pain)

    Measured: 96 hours post-operatively

Secondary outcomes (4)
  1. 24 Hour Use of Rescue Analgesic

    We will record the amount in milligrams and type of rescue analgesic for each patient.

    Measured: 24 hours post operatively

  2. 48 Hour Use of Rescue Analgesic

    We will record the amount in milligrams and type of rescue analgesic for each patient.

    Measured: 48 hours post operatively

  3. 72 Hour Use of Rescue Analgesic

    We will record the amount in milligrams and type of rescue analgesic for each patient.

    Measured: 72 hours post operatively

  4. 96 Hour Use of Rescue Analgesic

    We will record the amount in milligrams and type of rescue analgesic for each patient.

    Measured: 96 hours post operatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Feb 2020
  2. Study start22 Aug 2014
  3. Primary completion31 Dec 2017
  4. Study completion15 May 2019

Resources

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04278846
Sponsor's protocol ID
14-903
Status last verified
Jun 2022
First submitted
28 Dec 2016
Last updated
1 Jul 2022
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Depofoam bupivacaine and Bupivacaine hydrochloride (HCl) in people with Pain, Postoperative and Mammaplasty, run by The Cleveland Clinic 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 1 inclusion and 11 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 1 Jul 2022. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Jul 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

1 Hour Pain Assessment Numeric Rating Scale During Rest (time frame: 1 hour post-operatively). The study lists 20 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 1 Jul 2022.

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