The Efficacy of Liposomal Bupivacaine in Ultrasound Guided Supraclavicular Nerve Blocks for Hand and Wrist Surgery

Phase 4

Active, not recruiting

• Conditions: Hand Surgery; Wrist Surgery; Elbow Surgery; Fracture Fixation; Dupuytren Contracture; Finger Fracture; Wrist Arthropathy; Distal Radius Fracture
• Interventions: Drug: Dexamethasone; Drug: Liposomal bupivacaine (LB)

• Registration Number: NCT06806410
• Lead Sponsor: St. Luke's Hospital, Pennsylvania

Brief Summary

Patients undergoing hand, wrist, and elbow surgery may experience pain after surgery. The orthopedic surgeon may provide prescription pain medications after surgery to assist with pain control. However, with concern of the opioid epidemic, many patients would rather minimize the use of narcotic pain prescriptions after having surgery. As an alternative, ultrasound guided regional nerve blocks can assist with postoperative pain control.

patients consented to this study will be randomized into three groups: 1) will receive an ultrasound guided nerve block with local anesthesia only, 2) will receive an ultrasound guided nerve block with local anesthesia and a steroid dexamethasone, 3) will receive an ultrasound guided nerve block with liposomal bupivacaine.

our study team will make phone calls after surgery to the patient to determine how long the block lasted for, and how many opioid pain pills were taken up to 3 days after surgery.

Detailed Description

Our study team predicts that the ultrasound guided nerve block with liposomal bupivacaine can last approximately 48 hours, while the block with local anesthesia and dexamethasone will last approximately 30 hours, and the block with local anesthesia only may last up to 24 hours

Study Timeline

• Study Start: 2023-05-01
• Primary Completion: 2024-11-30
• Status Verified: 2025-01
• Study First Submitted: 2025-01-28
• Study First Submitted QC: 2025-01-28
• Study Completion: 2025-01-30
• Last Update Submitted: 2025-02-03
• Study First Posted: 2025-02-04
• Last Update Posted: 2025-02-06

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

• patients scheduled to undergo finger, hand, wrist, elbow surgery with a hand surgeon at St. Luke's University Hospital in Bethlehem, Pennsylvania
• patients greater than 18 years of age, able to provide written consent for surgery and study

Exclusion Criteria

• patients that cannot provide written consent for finger, hand, wrist, elbow surgery
• patients with known allergies to local anesthetics
• patients with severe liver disease
• patients with a condition known as methemoglobinemia

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Study Arm: local anesthesia with perineural dexamethasone	Dexamethasone	dexamethasone is a potent steroid that when provided in ultrasound guided nerve blocks can extend the duration of the nerve block.
Study Arm: liposomal bupivacaine	Liposomal bupivacaine (LB)	our study team would like to determine how use of liposomal bupivacaine in supraclavicular nerve blocks can lengthen the duration of the nerve block, and how it may affect the number of opioid pills used after surgery up until postoperative day three.

Primary Outcome Measures

Name	Time	Method
Subjective length of duration of block	feedback obtained up until day 3 after surgery	our study team contacts the patients 4 days after surgery to ask how long their regional nerve block lasted

Secondary Outcome Measures

Name	Time	Method
Number of opioid pills taken until postoperative day 3	feedback until day 3 after surgery	our study team contacts the patients to ask how many opioid pain pills were taken from arrival to home up until postoperative day 3

Trial Locations

Locations (1)

St. Luke's University Health Network; 🇺🇸 Bethlehem, Pennsylvania, United States