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Double-Blinded Randomized Controlled Study Investigating the Efficacy of Exparel (Liposomal Bupivacaine) for Postoperative Pain Relief in Mandibular Third Molar Extractions

Phase 4
Completed
Conditions
Post Operative Pain
Interventions
Registration Number
NCT05374499
Lead Sponsor
University of Southern California
Brief Summary

The most prevalent complaint after third molar extractions is pain. There have been many modalities and regimens developed to manage post-operative pain, such as modifications in surgical techniques, locally-applied medicaments, and oral analgesics. Recently, liposomal bupivacaine (Exparel) has been FDA approved for single-dose infiltration in the oral cavity in adults and children (6 years or older) to produce extended postsurgical local anesthesia. We hypothesize that the administration of liposomal bupivacaine (Exparel) at the end of third molar extractions will decrease postoperative pain and decrease narcotic use for pain management.

Detailed Description

In this study, we will prospectively collect data from all patients receiving bilateral third molar extractions with Exparel versus 0.5% bupivacaine 1:200,000 epinephrine (standard bupivacaine) injections to determine the efficacy of Exparel in reducing postoperative pain. Outcomes measured will be pain intensity based on a numeric scale, date and time when pain completely subsides for each side, adverse events, use of NSAID or acetaminophen outside of prescribed pain regimen, and use of narcotics. The purpose of this research project is to evaluate the use and efficacy of Exparel in postoperative pain management in third molar extractions.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
73
Inclusion Criteria
  • Patients receiving bilateral mandibular third molar extractions at the Herman Ostrow School of Dentistry by an oral & maxillofacial surgery resident.
Exclusion Criteria
  • Patient unable to complete form for four days postoperatively.
  • Patient with severe hepatic disease
  • Patient with a history of allergy or contraindication to amide-type LA or opioids
  • Patient with recent history of antibiotic use within the past thirty days
  • Patients with use of long-acting opioids, NSAIDs, aspirin, acetaminophen within 3 days prior to screening.
  • Patients who are pregnant.
  • Patients receiving additional mandibular teeth extractions.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Liposomal bupivacaineLiposomal bupivacaineA double-blinded randomization process will be used to preoperatively assign patient's left or right side to receive either Exparel (Liposomal bupivacaine) (39.9 mg/3 mL) or standard bupivacaine (5 mg/mL). At the end of the mandibular third molar extraction surgical procedure and at least twenty minutes following the most recent administration of 2% lidocaine with 1:100,000 epinephrine (routine for this procedure), all patients will receive one side of their mandibular infiltrations with 3mL of 1.3% liposomal bupivacaine (Exparel).
Primary Outcome Measures
NameTimeMethod
Post-operative pain96 hours post-operatively

At home questionnaire with a numerical scale (0 - 10), to be completed each morning and evening for four days post-operative.

Secondary Outcome Measures
NameTimeMethod
Adverse effects96 hours post-operatively

At home questionnaire including the presence or absence of any abnormal sensations, change in taste, nausea, constipation, fever, diaphoresis, vomiting, light-headedness, palpitations, or headache.

NSAID/Acetaminophen Use96 hours post-operatively

At home questionnaire including the dosage, time, quantity and reason for use.

Oxycodone Use96 hours post-operatively

At home questionnaire including the dosage, time, quantity and reason for use.

Trial Locations

Locations (1)

Herman Ostrow School of Dentistry of USC

🇺🇸

Los Angeles, California, United States

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