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Evaluating Postoperative Non-Opioid Pain Management Utilizing Local Anesthetics Coupled With Modulated Coagulation

Registration Number
NCT04814433
Lead Sponsor
NYU Langone Health
Brief Summary

This study is a prospective randomized trial examining the effect of topically combined antifibrinolytics (Tranexamic acid) with local anesthetics in all electively created surgical wound beds in hand surgery to provide long term pain relief and decrease the use of postoperative narcotics.

Detailed Description

The aim of the study is to provide long term pain relief and decrease the use of postoperative narcotics. All treatments are applied topically to the surgical bed prior to closure of the skin. Each of the drugs used in this study are Food and Drug Administration (FDA) approved and routinely used for pain relief. However, the route of administration of the drugs and addition of tranexamic acid or aminocaproic acid is considered off-label (outside of the FDA-approved indications) and therefore investigational.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Age 18 or older
  • Any patient undergoing elective hand surgery
Exclusion Criteria
  • Any patient with a traumatic open wound (only surgically created wounds will be included)
  • History of chronic pain
  • History of narcotic addiction
  • History of recreational drug dependency
  • History of psychiatric pathology
  • Allergy to local anesthetics, recombinant human thrombin or tranexamic acid
  • Any patient receiving a supra/infraclavicular block for anesthesia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Topical lidocaine and bupivacaine with thrombinRecombinant Human ThrombinIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin
Topical lidocaine and bupivacaine with thrombin and tranexamic acidRecombinant Human ThrombinIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 500 mg of tranexamic acid
Topical lidocaine and bupivacaine with thrombin and aminocaproic acidBupivacaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 1000 mg of aminocaproic acid
Topical lidocaine and bupivacaine with thrombinBupivacaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin
Topical lidocaine and bupivacaine with thrombin and tranexamic acidBupivacaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 500 mg of tranexamic acid
Topical lidocaine and bupivacaine aloneLidocaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine
Topical lidocaine and bupivacaine with thrombinLidocaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin
Topical lidocaine and bupivacaine with thrombin and tranexamic acidLidocaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 500 mg of tranexamic acid
Topical lidocaine and bupivacaine with thrombin and aminocaproic acidLidocaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 1000 mg of aminocaproic acid
Topical lidocaine and bupivacaine aloneBupivacaine Hydrochloride with EpinephrineIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine
Topical lidocaine and bupivacaine with thrombin and aminocaproic acidRecombinant Human ThrombinIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 1000 mg of aminocaproic acid
Topical lidocaine and bupivacaine with thrombin and tranexamic acidTranexamic acidIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 500 mg of tranexamic acid
Topical lidocaine and bupivacaine with thrombin and aminocaproic acidTranexamic acidIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 1000 mg of aminocaproic acid
Topical lidocaine and bupivacaine with thrombin and aminocaproic acidAminocaproic acidIn this treatment group, each solution will include 5 ml of 1% lidocaine, 5 ml of 0.25% bupivacaine, 10000 units of thrombin, and 1000 mg of aminocaproic acid
Primary Outcome Measures
NameTimeMethod
Change in Postoperative Pain ControlDay 1 preoperative , Day 14 postoperative

Measured by self-reported level of pain recorded in a daily pain diary made by the researchers from the day of the surgery until post-operative day 14. The levels of pain are scored in the following manner: 1-2 no pain, 3-4 mild pain, 5-6 moderate pain, 7-8 severe pain, 9-10 worst pain imaginable.

Secondary Outcome Measures
NameTimeMethod
Amount of Opioid Pain Medication Required PostoperativelyFrom Day 1 postoperative to Day 14 postoperative

Measured by self-reported number of pain pills taken postoperatively until post-operative day 14.

Total Time in Post Anesthesia Care Unit (PACU)From Day 1 postoperative until discharge from PACU (up to 1 day)

Trial Locations

Locations (1)

NYU Langone Health

🇺🇸

New York, New York, United States

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