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Local Anesthetic as Single Shot Versus Catheter in Patients Undergoing Video Assisted Thoracoscopic Surgery

Phase 2
Suspended
Conditions
Thoracic Surgery
Interventions
Drug: Liposomal Bupivacaine (EXPAREL®)/Bupivacaine
Registration Number
NCT04559347
Lead Sponsor
Poovendran Saththasivam
Brief Summary

The purpose of this research is to compare a single shot long acting local anesthetic to catheter infusion of local anesthetic in patients undergoing video assisted thoracoscopic (VAT) surgery.

Detailed Description

The purpose of this research is to compare Single Shot Liposomal Bupivacaine (EXPAREL®)/Bupivacaine (a long acting local anesthetic) to Ropivacaine (0.5% bolus followed by 0.2% infusion of local anesthetic using a catheter) in patients undergoing video assisted thoracoscopic (VAT) surgery.

Recruitment & Eligibility

Status
SUSPENDED
Sex
All
Target Recruitment
74
Inclusion Criteria
  • Subjects who are age > 18, undergoing video thoracoscopic surgery and following Guthrie Robert Packer Hospital's Enhanced Recovery After Surgery (ERAS) protocol for Thoracic Surgery.
Exclusion Criteria
  • weight < 50 kg, pregnant subjects,
  • left ventricular ejection fraction < 30%,
  • history of drug or narcotic abuse,
  • history of allergic to amide local anesthetic,
  • presence of contraindication for erector spinae plane block (local skin infection, sepsis, severe coagulopathy)
  • unable to provide consent,
  • unable to use pain rating scales as demonstrated by verbal feedback
  • preoperative chronic pain on narcotics,
  • history of renal insufficiency ( Creatinine > 1.5 mg/dl),
  • preoperative mild liver impairment ( i.e. AST/ALT above 1.5 times the upper normal limit)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Single Shot Liposomal Bupivacaine (EXPAREL®)/BupivacaineLiposomal Bupivacaine (EXPAREL®)/BupivacaineSingle Shot Liposomal Bupivacaine (EXPAREL®)/Bupivacaine for erector spinae block as local anesthetic
Continuous catheter infusion ropivacaineRopivacaine (0.5% bolus followed by 0.2% infusion)Ropivacaine (0.5% bolus followed by 0.2% infusion) using a continuous catheter for erector spinae plane block as local anesthetic
Primary Outcome Measures
NameTimeMethod
Numerical Rated Pain Scale (NRP)3 days post-operative

Patient reported pain scale (0-10)

Secondary Outcome Measures
NameTimeMethod
Post-operative opioid consumption3 days post-operative

Post-operative opioid consumption in morphine equivalents to determine total morphine.

Total Intraoperative narcoticAt end of surgery

Total opioids administered in the operating room surgery in morphine equivalents.

Total adjunct pain medication consumption3 days post-operative

Non-narcotic pain medications such as acetaminophen, gabapentin, ketorolac, etc.

Incentive spirometry changes from preoperative baseline to 3 days post-operative3 days post-operative

Incentive spirometry change from preoperative baseline to 3 days post-operative

Length of hospital stayFrom date of admission until date of discharge, an average of 3 days

Number of days from admission to discharge

Postoperative Quality of Recovery score (QOR-15)3 days post-operative

A survey on patient reported outcomes which consists of 15 questions related to five domains of patient reported health status (pain, physical comfort, physical independence, psychological support and emotional state). The score is reported on a scale from 0 to 150 with higher scores meaning a better outcome.

Adverse events frequencyup to 72 hours

Frequency and type of adverse events associated with Single Shot Liposomal Bupivacaine (Exparel)/Bupivacaine (SS) and Ropivacaine 0.5% BOLUS followed by Ropivacaine 0.2% continuous infusion

Trial Locations

Locations (1)

Robert Packer Hospital

🇺🇸

Sayre, Pennsylvania, United States

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