Clinical trial

Single-Shot Liposomal Bupivacaine vs. Liposomal Bupivacaine Combined With Dexamethasone Following Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial

Name
SHAM2023-2163
Description
Liposomal bupivacaine or Exparel (Pacira Biosciences) is a long-lasting nonopioid analgesic that was initially utilized as an infiltrative agent but has more recently become U.S. Food and Drug Administration (FDA) approved for use in interscalene brachial plexus nerve blockade as well as infiltrative blockade. Delivery in this form is reported to provide up to 72 hours of extended-release bupivacaine. Exparel's use as a regional anesthetic has also become increasingly common and has shown promise when utilized in Anterior Cruciate Ligament (ACL) reconstruction.
Trial arms
Trial start
2023-08-21
Estimated PCD
2024-10-30
Trial end
2024-10-30
Phase
Early phase I
Treatment
Exparel 30 mL
30 mL Liposomal bupivacaine (Exparel) evenly distributed and administered in adductor canal block
Arms:
Group 1: ACL repair + Exparel + nerve block, Group 2: ACL repair + Exparel + Dexamethasone + nerve block
0.5% bupivacaine
5 cc's of 0.5% bupivacaine evenly distributed and administered in adductor canal
Arms:
Group 1: ACL repair + Exparel + nerve block, Group 2: ACL repair + Exparel + Dexamethasone + nerve block
Dexamethasone
10 mg preservative free Dexamethasone evenly distributed and administered in adductor canal
Arms:
Group 2: ACL repair + Exparel + Dexamethasone + nerve block
iPACK block
iPACK (Infiltration between the Popliteal artery and Capsule of the Knee) block
Arms:
Group 1: ACL repair + Exparel + nerve block, Group 2: ACL repair + Exparel + Dexamethasone + nerve block
Size
154
Primary endpoint
Postoperative Pain
14 days
Postoperative opioid use
14 days
Postoperative Pain #2
14 days
Eligibility criteria
Inclusion Criteria: * Paticipants with ACL rupture amenable to reconstruction with BTB autograft identified in clinic by one of 4 different surgeons * Primary ACL Reconstruction with Autograft +/- Partial meniscectomy +/- Lateral extra-articular tenodesis * Age 18 and older * English speaking * Ability to complete surveys by phone or in person * Ability to provide informed consent Exclusion Criteria: * Revision cases * Multi-ligamentous knee injuries * Cartilage or meniscal procedures that prevent adherence to immediate weight bearing and range of motion rehab protocol * ACL reconstruction utilizing non-bone-patellar tendon-bone autografts * Allergies to study medications * Non-English speakers * Known alcohol or narcotic abuse history * Existing contract with a pain specialist due to underlying preoperative pain syndrome * Preoperative opioid use within the 3 months prior to surgery
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE4'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'DOUBLE', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER']}}, 'enrollmentInfo': {'count': 154, 'type': 'ESTIMATED'}}
Updated at
2023-08-23

1 organization