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Liposomal BupivacainePhase 4NCT06145165

A Analgesic Study of Adductor Canal &IPACK Block with Liposomal Bupivacaine in Knee Arthroplasty

A Phase 4 study testing Nerve block with ropivacaine and intravenous analgesia, Nerve block with liposomal bupivacaine and intravenous analgesia and Intravenous analgesia in people with Liposomal Bupivacaine and Postoperative Recovery, run by Nanjing First Hospital, Nanjing Medical University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

To study the effectiveness of ACB and iPACK block with liposomal bupivacaine for postoperative analgesia in patients undergoing knee arthroplasty Read more about this study

Who is it for?
Ages 18 to 79 yearsHealthy volunteers can take part
What is being tested?
Nerve block with ropivacaine and intravenous analgesia, Nerve block with liposomal bupivacaine and intravenous analgesia and Intravenous analgesia
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
90 participants
Where
1 siteChina
Study dates
10 Dec 2023to 31 Dec 2024
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 79 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 18-79 years.
  • Patients undergoing unilateral total knee arthroplasty or unicondylar joint replacement.
  • Normal diet.
  • ASA grade I~Ⅲ;
  • BMI 18-30kg /m2.
  • No intraspinal anesthesia contraindications.

Who cannot join

  • Patients with severe neurological diseases.
  • Hearing and speech impaired.
  • Preoperative gastric emptying disorders, such as gastrointestinal obstruction, gastroesophageal reflux, or previous gastrointestinal surgery, etc.
  • Patients with severe renal insufficiency or other severe metabolic diseases.
  • Mental disorders, alcoholism or a history of drug abuse.
  • The surgical time is greater than 3 hours.
  • Puncture site infection, abnormal coagulation function, and local anesthetic allergy.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Nanjing First Hospital

    Nanjing, Jiangsu, 210006

    Liu Han, MD, 18951670163, han_cold.student@sina.com

    Recruiting

Other trials in China

About this study

Official title: A Analgesic Study of Adductor Canal &IPACK Block with Liposomal Bupivacaine in Knee Arthroplasty :A Randomized,Double-controlled,Parallel-controlled,Single-center Study

To study the effectiveness of ACB and iPACK block with liposomal bupivacaine for postoperative analgesia in patients undergoing knee arthroplasty

Read the detailed description

The pain after knee arthroplasty limits the patient's activities and postoperative recovery, and currently there are mainly three analgesic methods: intravenous analgesia, epidural analgesia and nerve block analgesia. There is a lack of studies on whether liposomal bupivacaine, if used for ACB and iPACK block, can achieve benefits in knee arthroplasty pain management by prolonging sensory nerve block without affecting muscle strength, improving patient prognosis, and shortening hospitalization days.

In this study, in order to better evaluate the effect of liposomal bupivacaine for ACB and iPACK biock on the prognosis of patients undergoing knee arthroplasty, not only the NRS and AUC of patients in each group will be observed, but also the postoperative QoR-15 Quality of Recovery Rating Scale, postoperative nausea, vomiting and other complications, and the number of hospitalization days will be also included as observation indicators. The completion of this study can provide a clinical basis for the selection of analgesic regimens for knee arthroplasty, and also provide strong evidence-based medical support for the relevant medical decision making of government departments.

Being tested
Nerve block with ropivacaine and intravenous analgesia, Nerve block with liposomal bupivacaine and intravenous analgesia, Intravenous analgesia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nerve block with ropivacaine and intravenous analgesiaOther

    When the MOAA/S score is 5 after the surgery,the PCIA pump equipped with sufentanil injection will be connected,if the patient's resting NRS ≥ 4 points , they should be given sufentanil 5 ug intravenously at intervals of more than 8 minutes until NRS ≤ 3.

  • Nerve block with liposomal bupivacaine and intravenous analgesiaCombination product

    When the MOAA/S score is 5 after the surgery,the PCIA pump equipped with sufentanil injection will be connected,if the patient's resting NRS ≥ 4 points , they should be given sufentanil 5 ug intravenously at intervals of more than 8 minutes until NRS ≤ 3.

  • Intravenous analgesiaOther

    When the MOAA/S score is 5 after the surgery,the PCIA pump equipped with sufentanil injection will be connected,if the patient's resting NRS ≥ 4 points , they should be given sufentanil 5 ug intravenously at intervals of more than 8 minutes until NRS ≤ 3.

Study groups in NCT06145165
Study groupRoleWhat they receive
RP group:Nerve block with ropivacaine and intravenous analgesia groupPlacebo comparatorThe ropivacaine group will use ultrasound high-frequency line array probe for ACB and convex array probe for iPACK block before induction of general anesthesia
Receives: Other: Nerve block with ropivacaine and intravenous analgesia
LP group :Nerve block with liposomal bupivacaine and intravenous analgesia groupExperimentalThe liposomal bupivacaine group will use ultrasound high-frequency line array probe for ACB and convex array probe for iPACK block before induction of general anesthesia
Receives: Combination Product: Nerve block with liposomal bupivacaine and intravenous analgesia
control group:Intravenous analgesia groupPlacebo comparatorGeneral anesthesia was induced directly
Receives: Other: Intravenous analgesia

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The cumulative use of analgesic drugs (sufentanil,calculated in ug)up to 48 hours postoperative in each group

    To study the effectiveness of ACB and iPACK block with liposomal bupivacaine for postoperative analgesia in patients undergoing knee arthroplasty.A lower dose of analgesics indicates a longer duration of block.

    Measured: Up to 48 hours postoperative

Secondary outcomes (10)
  1. NRS scores at rest and during exerciseat at 2 hours, 4 hours, 8 hours, 12 hours, 24 hours, 36 hours, 48 hours and 72 hours postoperative

    The NRS typically consists of a straight line with numbers ranging from 0 to 10. Each number corresponds to a level of pain intensity:0: No pain.1 to 3: Mild pain (low intensity). 4 to 6: Moderate pain (moderate intensity). 7 to 10: Severe pain (high intensity) Patients are asked to choose a number that best represents their current pain level, where 0 means no pain, and 10 indicates the worst possible pain.A lower NRS score indicates a longer duration of block.

    Measured: at 2 hours, 4 hours, 8 hours, 12 hours, 24 hours, 36 hours, 48 hours and 72 hours postoperative

  2. The total number of PCIA compressions on the first day,the second day and the third day after surgery.

    Fewer total PCIA compressions indicated a longer duration of block.

    Measured: On the first day,the second day and the third day after surgery.

  3. The number of effective PCIA compressions on the first day,the second day and the third day after surgery.

    Fewer total effective PCIA compressions indicated a longer duration of block.

    Measured: On the first day,the second day and the third day after surgery.

  4. The number of times of remedial analgesia on the first day,the second day and the third day after surgery.

    Fewer times of rescue analgesia indicated a longer duration of analgesia.

    Measured: On the first day,the second day and the third day after surgery.

  5. The cumulative use of analgesic drugs (sufentanil,calculated in ug)on the first day,the second day and the third day after surgery.

    Less cumulative use of analgesics indicates a longer duration of block

    Measured: On the first day,the second day and the third day after surgery.

  6. The percentage of subjects who did not use remedial analgesics on the first day,the second day and the third day after surgery.

    A greater percentage of subjects who did not use rescue analgesics indicated a longer duration of analgesic block.

    Measured: On the first day,the second day and the third day after surgery.

  7. Satisfaction score of subjects on the first day,the second day and the third day after surgery.

    Rated on a 0-10 scale, with a higher score representing greater satisfaction.

    Measured: On the first day,the second day and the third day after surgery.

  8. Satisfaction score of surgeons on the first day,the second day and the third day after surgery.

    Rated on a 0-10 scale, with a higher score representing greater satisfaction.

    Measured: On the first day,the second day and the third day after surgery.

  9. Both the liposomal bupivacaine group and the ropivacaine group were subjected to ACB and iPACK block. Area under the pain intensity-time curve within 72 hours after the first postoperative dose(PI-AUC72)was observed in the three groups.

    A smaller PI-AUC72 indicates a longer duration of nerve block.

    Measured: within 72 hours after the first postoperative initiation of drug administration

  10. 15-item Quality of Recovery Rating Scale (QoR-15): 24hours, 48hours and 72hours postoperatively

    QoR-15 was used to assess five aspects of postoperative recovery quality (physical comfort, physical independence, psychological support, emotion and pain), with higher scores indicating the higher postoperative recovery quality. The lowest score is 0 points, and the highest score is 150 points.

    Measured: at 24 hours, 48 hours and 72 hours postoperative

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted24 Nov 2023
  2. Study start10 Dec 2023
  3. Primary completion31 Dec 2024 (estimated)
  4. Study completion31 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Investigator
Enrolment
90 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06145165
Sponsor's protocol ID
KY20230829-05
Status last verified
Nov 2023
First submitted
27 Oct 2023
Last updated
23 Sep 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kukreja P, Feinstein J, Kalagara HK, Huntley SR, Lee SR, Naranje S, Shah A. A Summary of the Anatomy and Current Regional Anesthesia Practices for Postoperative Pain Management in Total Knee Arthroplasty. Cureus. 2018 Jun 7;10(6):e2755. doi: 10.7759/cureus.2755.

    PubMed 30094112
  • Sundarathiti P, Ruananukul N, Channum T, Kitkunasathean C, Mantay A, Thammasakulsiri J, Sodsee W. A comparison of continuous femoral nerve block (CFNB) and continuous epidural infusion (CEI) in postoperative analgesia and knee rehabilitation after total knee arthroplasty (TKA). J Med Assoc Thai. 2009 Mar;92(3):328-34.

    PubMed 19301724
  • Fedriani de Matos JJ, Atienza Carrasco FJ, Diaz Crespo J, Moreno Martin A, Tatsidis Tatsidis P, Torres Morera LM. Effectiveness and safety of continuous ultrasound-guided femoral nerve block versus epidural analgesia after total knee arthroplasty. Rev Esp Anestesiol Reanim. 2017 Feb;64(2):79-85. doi: 10.1016/j.redar.2016.05.008. Epub 2016 Jul 9. English, Spanish.

    PubMed 27400891
  • Yu YL, Cao DH, Chen B, Yang ZH, You KZ. Continuous femoral nerve block and patient-controlled intravenous postoperative analgesia on Th1/Th2 in patients undergoing total knee arthroplasty. J Biol Regul Homeost Agents. 2018 May-Jun;32(3):641-647.

    PubMed 29921393
  • Vora MU, Nicholas TA, Kassel CA, Grant SA. Adductor canal block for knee surgical procedures: review article. J Clin Anesth. 2016 Dec;35:295-303. doi: 10.1016/j.jclinane.2016.08.021. Epub 2016 Oct 11.

    PubMed 27871547
  • Mou P, Wang D, Tang XM, Zeng WN, Zeng Y, Yang J, Zhou ZK. Adductor Canal Block Combined With IPACK Block for Postoperative Analgesia and Function Recovery Following Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Study. J Arthroplasty. 2022 Feb;37(2):259-266. doi: 10.1016/j.arth.2021.10.004. Epub 2021 Oct 13.

    PubMed 34653576
  • Hasabo EA, Assar A, Mahmoud MM, Abdalrahman HA, Ibrahim EA, Hasanin MA, Emam AK, AbdelQadir YH, AbdelAzim AA, Ali AS. Adductor canal block versus femoral nerve block for pain control after total knee arthroplasty: A systematic review and Meta-analysis. Medicine (Baltimore). 2022 Aug 26;101(34):e30110. doi: 10.1097/MD.0000000000030110.

    PubMed 36042669
  • Hussain N, Brull R, Sheehy B, Dasu M, Weaver T, Abdallah FW. Does the addition of iPACK to adductor canal block in the presence or absence of periarticular local anesthetic infiltration improve analgesic and functional outcomes following total knee arthroplasty? A systematic review and meta-analysis. Reg Anesth Pain Med. 2021 Aug;46(8):713-721. doi: 10.1136/rapm-2021-102705. Epub 2021 May 14.

    PubMed 33990436

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Nerve block with ropivacaine and intravenous analgesia, Nerve block with liposomal bupivacaine and intravenous analgesia and Intravenous analgesia in people with Liposomal Bupivacaine and Postoperative Recovery, run by Nanjing First Hospital, Nanjing Medical University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 23 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Liu Han (18951670163, han_cold.student@sina.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The cumulative use of analgesic drugs (sufentanil,calculated in ug)up to 48 hours postoperative in each group (time frame: Up to 48 hours postoperative). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06145165, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Sep 2024.

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