Clinical trial

A Non-Inferiority Randomized Trial Comparing the Impact of Thoracic Epidural Analgesia Versus Surgical Site Infiltration With Liposomal Bupivicaine on the Postoperative Recovery of Patients Following Open Gynecologic Surgery

Name
J17157
Description
The goal of this study is to test the hypothesis that surgical site infiltration with liposomal bupivacaine (LB) is non-inferior to and more cost effective than thoracic epidural analgesia (TEA) for patients undergoing open gynecologic surgery on an established enhanced recovery program (ERP) using a non-inferiority randomized trial design. The impact of TEA and surgical site infiltration with LB on neuroendocrine and inflammatory mediators of surgical stress response (SSR) will also be investigated as a translational endpoint.
Trial arms
Trial start
2021-04-14
Estimated PCD
2024-09-01
Trial end
2025-09-01
Status
Recruiting
Phase
Early phase I
Treatment
Liposomal bupivacaine
Surgical site infiltration with 20 mL liposomal bupivacaine prior to laparotomy closure.
Arms:
Arm 2: Surgical Site Infiltration with Liposomal Bupivacaine
Other names:
Exparel
Thoracic epidural analgesia (bupivacaine)
Perioperative bupivacaine based thoracic epidural placed preoperatively.
Arms:
Arm 1: Thoracic Epidural Analgesia with bupivicaine
Size
100
Primary endpoint
Analgesia as assessed by pain intensity scores on a visual analog scale
0 to 48 hours postoperatively
Total opioid consumption
0 to 48 hours postoperatively
Eligibility criteria
Inclusion Criteria: * Individuals ≥ 18 years of age * Planned laparotomy by the gynecologic oncology service at the sponsor institution. Exclusion Criteria: * Individuals who have a contraindication to thoracic epidural analgesia * Individuals with a coagulation disorder * Individuals with an infection at the site of epidural placement * Individuals with intracranial pathology such as non-communicating increased intracranial pressure or obstruction of cerebrospinal fluid flow related to mass lesions * Individuals with spinal pathology: abnormal spine anatomy, surgical fusion, or spinal column lesions * Individuals who have a contraindication to liposomal bupivacaine * Individuals with a known allergic reaction to liposomal bupivacaine * Individuals with Childs-Pugh Class B or C liver disease * Individuals who have a history of long-term opioid use for chronic pain, defined as use of opioid pain medications for ≥4 weeks prior to surgery.
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE3'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 100, 'type': 'ESTIMATED'}}
Updated at
2023-06-18

1 organization

1 product

2 indications

Indication
Surgery
Indication
Analgesic