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Completed

NCT Number: NCT03106519

Liposome Bupivacaine for WRIST Blocks

Treatment of Dupuytren's contracture requires multiple injections into the palm of the hand to weaken the cords, followed by rupture of the strands 2 days later. Anesthesia is required for both phases of treatment. It is hypothesized that extended-release liposome bupivacaine prolongs nerve blockade of the wrist allowing patients to undergo this 2-part regimen with less pain.

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Key information

Age range

18 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Ziekenhuis Oost-Limburg

Genk, B-3600, Belgium

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female, at least 18 years and max 85 years of age at screening
  • Scheduled to undergo Dupuytren's contracture release
  • American Society of Anesthesiologists (ASA) physical status I, II or III
  • Able to demonstrate sensory function by exhibiting sensitivity to cold, pinprick and light touch
  • Female subjects must be surgically sterile or have a monogamous partner who is surgically sterile; at least 2 years postmenopausal; or practicing abstinence; or using an insertable, injectable, transdermal, or combination oral contraceptive approved by the FDA for greater than 2 months prior to screening and commit to the use of an acceptable form of birth control for the duration of the study and for 30 days after completion of the study
  • Able to understand the English or Dutch language, purpose and risks of the study
  • Able to provide informed consent and authorization to use protected health information, adhere to the study visit schedule and complete all study assessments

Exclusion criteria

  • Currently pregnant, nursing or planning to become pregnant during the study or within 1 moth after study drug administration
  • History of hypersensitivity to local anesthetics
  • Contraindication to bupivacaine, paracetamol, ketorolac, oxycodone or morphine
  • Medical condition that will make it difficult to assess sensory distributions of peripheral nerves or to communicate with staff
  • Chronic scheduled use of any of the following medications within the times specified before surgery: long-acting opioid medication or NSAIDs (except for low-dose aspirin used for cardioprotection) within 3 days, or any opioid medication within 24 hours
  • Suspected or known recent history (< 3 months) of drug or alcohol abuse
  • Concurrent physical condition that may require analgesic treatment (such as NSAID or opioid) in the postsurgical period for pain that is not strictly related to Dupuytren's contracture and which may confound the postsurgical assessments
  • Infection at the planned block site
  • Initiation of treatment with any of the following medications within 1 month of study drug administration or if the medication(s) are being given to control pain: selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), gabapentin, pregabalin (Lyrica®), or duloxetine (Cymbalta®)
  • Use of dexmedetomidine HCl (Precedex®) within 3 days of study drug administration
  • Body weight <40 kg (88 pounds) or a body mass index >44 kg/m2
  • Uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments
  • Any chronic neuromuscular deficit affecting the peripheral nerves or muscles of the surgical extremity
  • Any chronic condition or disease that would compromise neurological or vascular assessments
  • Presence of preexisting coagulation disorders
  • Baseline neurological deficits
  • History of impaired kidney function, chronic respiratory disease, rheumatoid arthritis, coagulopathy or loss of sensation in the extremities
  • Impaired kidney function (e.g., serum creatinine level >2 mg/dL [176.8 µmol/L] or blood urea nitrogen level >50 mg/dL [17.9 mmol/L]) or impaired liver function (e.g., serum aspartate aminotransferase [AST] level >3 times the upper limit of normal (ULN) or serum alanine aminotransferase [ALT] level >3 times the ULN
  • Previous participation in an EXPAREL study
  • Administration of an investigational drug within 30 days or 5 elimination half-lives of such investigational drug, whichever is longer, prior to study drug administration, or planned administration of another investigational product or procedure during the subject's participation in this study

Treatment and study plan

Liposome bupivacaine + bupivacaine

Drug

Primary outcomes

  1. Change in current pain over the first postoperative week

    Time frame: From baseline (before nerve block) through first postoperative week

    Pain rating (NRS) at rest and with movement

Secondary outcomes

  1. Change in worst pain over the first postoperative week

    Time frame: From discharge from hospital through first postoperative week

    Modified BRIEF Pain Inventory (Q1)

  2. Change in ability to use hand

    Time frame: From discharge from hospital through first postoperative week

    Hold Styrofoam cup

  3. Change in sleep quality

    Time frame: From discharge from hospital through first postoperative week

    Duration (h), quality rating (0 - 10)

  4. Change in satisfaction with pain control

    Time frame: From discharge from hospital through first postoperative week

    With pain control (0 - 10)

  5. Change in sensory response in skin dermatomes

    Time frame: From beginning of nerve block through first postoperative week

    Cold, pinprick, light touch in the medial and ulnar nerve dermatomes

  6. Change in motor response in thumb and fingers

    Time frame: From beginning of nerve block through first postoperative week

    Abduction/adduction thumb/fingers

Other outcomes

  1. Total number of participants with side effects to regional anesthesia peripheral nerve blockade

    Time frame: From beginning of nerve block through first postoperative week

    Nausea, vomiting, fever, constipation, severe itching of the skin, dizziness, sleepless nights, excessive sweating, urinary retention, headache, heart palpitations

  2. Participants with adverse events

    Time frame: From date of signing ICF through the first postoperative week

    Any untoward medical occurrence (unfavorable and/or unintended change in a body structure or body function) associated with the use of a drug in humans, whether or not considered drug related

Sponsors and collaborators

Lead sponsor

Catherine Vandepitte, M.D.

Other

Collaborators

  • Pacira Pharmaceuticals, Inc

Registry information

Official study title

Distal Extremity (Wrist) Nerve Blocks With a Mixture of Liposome Bupivacaine + Bupivacaine Versus Bupivacaine Alone for Patients Having Dupuytren's Contracture Release: a Blinded Randomized Controlled Trial

Important dates

Study start
2017
Primary completion
2017
Study completion
2017
First posted
Apr 10, 2017
Registry last updated
Sep 10, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.