MedPath

Utility of Liposomal Bupivacaine Transversus Abdominal Plane Block for Open Myomectomy

Phase 4
Recruiting
Conditions
Fibroid Uterus
Interventions
Registration Number
NCT04272086
Lead Sponsor
Icahn School of Medicine at Mount Sinai
Brief Summary

The study team will be randomizing patients presenting for open myomectomy to either received transversus abdominal plane blocks with either liposomal bupivacaine or standard bupivacaine. The study team will be analyzing the impact of local anesthetic on opiate consumption as the investigator's primary endpoint with other secondary endpoints.

Detailed Description

After consent, patients will be randomized to either liposomal bupivacaine Transversus Abdominal Plane (TAP) vs standard bupivacaine TAP. Blocks will occur post induction and pre incision. Only the block team (not the anesthesia team nor the care team) will be unblinded and they will not have any impact on the data collection. The entire care team and the patient will be blinded. A standardized anesthetic regimen will be employed followed by a prescriptive post-operative pain management plan aimed at enhanced recovery. Patients will be followed for up to 96 hours and asked about their opiate consumption, pain scores, side effects, and recovery.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
140
Inclusion Criteria
  • Not pregnant
  • Weight over 50kg presenting for open myomectomy
  • No history of allergy to any study medication
  • No history of malignant ventricular dysrhythmia, epilepsy, seizure disorder, or chronic pain syndrome other than pain from myomas
  • No history of drug or alcohol use or abuse disorder or pre-existing liver disease.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Liposomal bupivacaine TAPBupivacaine liposomeTAP block with 10mL liposomal bupivacaine, 20mL 0.25% bupivacaine, and 10mL normal saline for a total of 40 mL per side
Bupivacaine TAPnormal salineTAP block with 30 mL 0.25% bupivacaine mixed with 10 mL normal saline for a total of 40 mL per side
Liposomal bupivacaine TAPnormal salineTAP block with 10mL liposomal bupivacaine, 20mL 0.25% bupivacaine, and 10mL normal saline for a total of 40 mL per side
Liposomal bupivacaine TAPBupivacaineTAP block with 10mL liposomal bupivacaine, 20mL 0.25% bupivacaine, and 10mL normal saline for a total of 40 mL per side
Bupivacaine TAPBupivacaineTAP block with 30 mL 0.25% bupivacaine mixed with 10 mL normal saline for a total of 40 mL per side
Primary Outcome Measures
NameTimeMethod
Morphine Equivalents at 72 Hours72 hours

Total cumulative opiates consumed converted to morphine equivalents

Secondary Outcome Measures
NameTimeMethod
Area under the curve pain scale at 96 hours96 hours

Sum of pain scores at 24, 48, 72, and 96 hours. Pain scale from 0-10, with higher score indicating worst pain.

Quality of Recovery at 48 hours48 hours

15 question quality of recovery scale, full scale from 0-150, with lower score indicating better recovery.

Morphine Equivalents at 96 Hours96 hours

Total cumulative opiates consumed converted to morphine equivalents

Morphine Equivalents at 48 Hours48 hours

Total cumulative opiates consumed converted to morphine equivalents

Opiate Sparing Criteria at 72 hours72 hours

Composite score of minimal opiate dose and additionally scores of 0 on questions 2,3,4,5,6 on OBAS scoring scale.

Overall Benefit of Analgesic Score (OBAS) scoring scale -total scale from 0-20, low score indicates high benefit.

Quality of Recovery at 72 hours72 hours

15 question quality of recovery scale, full scale from 0-150, with lower score indicating better recovery.

Trial Locations

Locations (1)

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

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