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Postoperative Acute PainPhase 4NCT07171125

Liposomal Bupivacaine for Pain After Lumbar Fusion

A Phase 4 study testing Liposomal bupivacaine (local infiltration) and ropivacaine (local infiltration) in people with Postoperative Acute Pain and Lumbar Degenerative Diseases, run by Min Li at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Spine surgery often causes severe postoperative pain. Currently, our hospital routinely uses ropivacaine for local infiltration analgesia (lasting 6-8 hours). This study evaluates liposomal bupivacaine, a novel long-acting local anesthetic providing up to 72 hours of pain relief, in patients undergoing posterior… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Liposomal bupivacaine (local infiltration) and ropivacaine (local infiltration)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
204 participants
Where
1 siteChina
Study dates
20 Sep 2025to 3 Mar 2026
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years;
  • ASA physical status class I-III;
  • Scheduled for elective 1- or 2-level posterior lumbar surgery: Decompression (laminectomy/discectomy) and fusion with internal fixation

Who cannot join

  • Chronic pain disorders requiring ≥30 mg oral morphine equivalents/day for >3 months.
  • Pre-existing neurological deficits that may interfere with pain assessment.
  • Hypersensitivity to any component of multimodal analgesia or local anesthetics (e.g., bupivacaine, ropivacaine).
  • Acute systemic/local infection (e.g., surgical site infection, sepsis).
  • Metastatic spinal malignancies (confirmed by imaging/histopathology).
  • Pregnancy or lactation.
  • Patient refusal after detailed protocol explanation.
  • Other investigator-determined high-risk conditions.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Peking University Third Hospital

    Beijing

Other trials in China

About this study

Official title: Liposomal Bupivacaine for Acute Pain Management Following Posterior Lumbar Decompression and Fusion Surgery in Adults: A Prospective, Randomized Controlled Trial

Spine surgery often causes severe postoperative pain. Currently, our hospital routinely uses ropivacaine for local infiltration analgesia (lasting 6-8 hours). This study evaluates liposomal bupivacaine, a novel long-acting local anesthetic providing up to 72 hours of pain relief, in patients undergoing posterior lumbar spine surgery. Through a randomized controlled design, we will compare the two drugs' effects on pain control within 72 hours and opioid consumption. Both regimens are guideline-recommended and safe.

Being tested
Liposomal bupivacaine (local infiltration), ropivacaine (local infiltration)
Keywords
Liposomal bupivacaine, Local infiltration analgesia, Posterior lumbar fusion, Postoperative pain, Randomized controlled trial, Opioid-sparing
Medical subject headings
Pain, Postoperative

What participants receive

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

  • Liposomal bupivacaine (local infiltration)Drug

    Patients will receive a pre-closure local infiltration of 266 mg liposomal bupivacaine (20 mL for single-level surgery; 30 mL for two-level surgery) combined with 25 mg bupivacaine hydrochloride (10 mL total volume). The drug will be injected bilateral into the paraspinal muscles and subcutaneous tissues prior to wound closure. This provides both immediate (bupivacaine HCl) and prolonged (liposomal) analgesia."

  • ropivacaine (local infiltration)Drug

    Patients will receive 120 mg ropivacaine diluted to 30 mL (single-level) or 40 mL (two-level) with normal saline. The solution will be infiltrated bilateral into the paraspinal muscles and subcutaneous tissues using the same technique as the experimental arm, ensuring consistent injection depth and distribution.

Study groups in NCT07171125
Study groupRoleWhat they receive
Liposomal Bupivacaine GroupExperimental266 mg liposomal bupivacaine + 25 mg bupivacaine HCl, local infiltration during closure
Receives: Drug: Liposomal bupivacaine (local infiltration)
Ropivacaine GroupActive comparator120 mg ropivacaine, local infiltration during closure.
Receives: Drug: ropivacaine (local infiltration)

What is being measured

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

  1. Total opioid consumption within 72 hours postoperatively (converted to morphine milligram equivalents, MME)

    Opioid doses will be converted to MME using the CDC standard conversion table

    Measured: 72 hours postoperative

Secondary outcomes (18)
  1. Postoperative pain intensity assessed by Numeric Rating Scale (NRS, 0-10) at rest and during movement (e.g., coughing/ambulation) at predefined timepoints: pre-PACU discharge, 4h, 8h, 24h, 48h, and 72h after surgery.

    NRS ranges from 0 (no pain) to 10 (worst imaginable pain). Movement-associated pain will be assessed during standardized activities (e.g., coughing on command or first ambulation).All assessors will be trained to ensure consistent NRS measurement across timepoints.

    Daytime assessments: Performed within ±30 minutes of scheduled timepoints

    Nighttime adjustments:

    Assessments falling between 21:00 (9:00 PM) and 07:00 (7:00 AM) will be deferred to 08:00 AM the following morning to avoid sleep disruption.

    Original timepoints documented with annotations (e.g., "Scheduled: 02:00; Assessed: 08:00+1")

    Measured: Immediately prior to PACU discharge,4 hours, 8 hours, 24 hours, 48 hours, and 72 hours after surgery.

  2. Total postoperative morphine consumption via PCA

    PCA settings will be standardized across all patients:

    • Bolus dose: 1 mg morphine equivalent
    • Lockout interval:10 minutes
    • No background infusion.

    Measured: Cumulative consumption recorded at 4 hours, 8 hours, 24 hours, 48 hours, and 72 hours after surgery

  3. Total Postoperative Rescue Tramadol Consumption

    Trigger Criteria: NRS >3 at rest despite PCA morphine (1mg bolus, 10min lockout).

    Dosing Protocol: Tramadol 50mg IV/oral

    Data Collection:

    Cumulative tramadol consumption recorded at 4hours, 8hour, 24hours, 48hours, 72hours after surgery.

    Convert oral to IV equivalent for analysis

    Measured: From PCA initiation until 72 hours (Day3) postoperatively. Rescue tramadol consumption will be recorded at 4hours, 8hour, 24hours, 48hours, 72hours after surgery.

  4. Sleep disturbance due to pain (binary scale)

    Patients will report whether pain interfered with sleep during the previous night using a standardized binary scale:

    • 0: No sleep disruption (pain did not awaken or prevent sleep)
    • 1: Sleep disrupted (pain caused awakening or difficulty falling asleep).

    Assessment Protocol:

    Evaluated each morning at 8:00 AM by trained research staff Covers sleep quality during the preceding night (20:00-07:59) Delayed assessment for nighttime surgeries: If surgery ends after 18:00, first assessment deferred to 8:00 AM on postoperative Day 1

    Measured: Postoperative Days 1 (24 hours), 2 (48 hours), and 3 (72 hours), with daily assessment window: 8:00-9:00 AM

  5. Time to first independent ambulation

    Definition: Hours from surgery end to first unassisted walking >5 meters

    Measured: From surgery completion until event occurs, assessed up to 72 hours postoperatively

  6. Immediate local anesthetic-related complications (0-2 hours)

    All complications will be recorded and graded. Immediate events (0-2h):

    • Local anesthetic systemic toxicity (LAST): CNS/CV symptoms (e.g., seizures, arrhythmias)
    • Allergic reactions: urticaria, bronchospasm, anaphylaxis

    Measured: From local anesthetic infiltration completion through 2 hours post-procedure.

  7. Incidence of nausea/vomiting (PONV)

    Graded by severity: 1=Mild (no rescue), 2=Moderate (required 1 antiemetic), 3=Severe (≥2 antiemetics or prolonged NPO).

    Standardized Assessment Protocol at fixed timepoints:

    Day 1: 0-24 hours postoperatively Day 2: 24-48 hours postoperatively Day 3: 48-72 hours postoperatively

    Assessment window:

    Performed daily at 08:00 AM for previous 24-hour period Evening surgeries (end time >18:00): First assessment at 08:00 AM on Day 1

    Symptom tracking:

    Nursing staff document all emetic episodes and antiemetic administrations in real-time

    Measured: From surgery completion through 72 hours (Day 3) postoperatively, with interval reporting: 0-24 hours (Day 1), 24-48 hours (Day 2), 48-72 hours (Day 3).

  8. Pruritus severity

    Rated by patients: 0=None, 1=Mild (no treatment), 2=Moderate (topical therapy), 3=Severe (systemic treatment).

    Measured: From surgery completion through 72 hours (Day 3) postoperatively, with interval analyses: 0-24 hours (Day 1),24-48 hours (Day 2),48-72 hours (Day 3)

  9. Incidence of Postoperative Urinary Retention Requiring Catheterization

    Definition \& Assessment Protocol:

    Diagnostic Criteria: Bladder volume ≥600 mL (ultrasound-confirmed) + inability to void spontaneously.

    Catheterization threshold: Pain (VAS ≥4) with bladder volume ≥600 mL, OR No voiding for 8 hours + bladder volume ≥400 mL.

    Data Collection:

    Event-driven assessments: Triggered by patient-reported symptoms. Maximum observation period: 72 hours (Day 3).

    Measured: From surgery completion through 72 hours (Day 3) postoperatively, with planned intervals: 0-24 hours (Day 1), 24-48 hours (Day 2), 48-72 hours (Day 3).

  10. Postoperative Sedation Levels Assessed by Ramsay Scale

    Ramsay Scale:

    1. Patient anxious/agitated
    2. Cooperative/oriented
    3. Responds to commands only
    4. Asleep but brisk response to stimulus
    5. Sluggish response
    6. No response.

    Scoring Direction: Higher scores indicate deeper sedation (1=inadequate, 6=excessive).

    Clinical Thresholds:

    Target range: RSS 2-4 (ERAS-recommended optimal sedation) Intervention triggers: RSS ≥5 (reduce sedation), RSS ≤1 (rescue analgesia)

    Assessment Protocol

    Fixed Timepoints:

    4 hours (Postoperative Day 0) 8 hours (Postoperative Day 0) 24 hours (Postoperative Day 1) 48 hours (Postoperative Day 2) 72 hours (Postoperative Day 3)

    Nighttime Adjustment:

    Assessments between 21:00-07:00 deferred to 08:00 next morning Data Collection Window: ±30 minutes at each timepoint

    Standardized Stimuli:

    Verbal: "Open your eyes" at 70 dB Tactile: Shoulder shaking with 500g pressure

    Measured: From anesthesia emergence until 72 hours postoperatively, at Fixed timepoints: 4 hours, 8 hours, 24 hours, 48 hours and 72 hours after surgery.

  11. Incidence of Postoperative Delirium Assessed by 3D-CAM (3-Minute Diagnostic Interview for CAM-Defined Delirium)

    3D-CAM assesses: 1) Acute onset, 2) Inattention, 3) Disorganized thinking, 4) Altered consciousness. Administered by trained research assistants blinded to group allocation.

    Primary Assessment Points:

    24 hours (Postoperative Day 1) 48 hours (Postoperative Day 2) 72 hours (Postoperative Day 3)

    Evaluation Window:

    ± 30 min at each timepoint. Nighttime detections (21:00-07:00) formally assessed at 08:00 next morning

    Measured: From anesthesia emergence through 72 hours postoperatively: Primary Assessment Points: 24 hours (Postoperative Day 1) 48 hours (Postoperative Day 2) 72 hours (Postoperative Day 3)

  12. PCA demand attempts

    Unit of Measure: Number of attempts

    Measured: Counted over consecutive intervals: 0-4 hours, 4-8 hours, 8-24 hours, 24-48 hours, and 48-72 hours postoperatively

  13. PCA delivery/demand ratio

    Calculation: (Number of successful PCA deliveries / Number of PCA demand attempts) × 100

    Measured: Calculated for each interval: 0-4hours, 4-8hours, 8-24hours, 24-48hhours, 48-72hours after surgery.

  14. Time to first PCA attempt

    Measured: Recorded from end of surgery until first PCA button press

  15. Time to first tolerated oral intake

    Definition: Hours from surgery end to first clear liquid intake (≥50 mL) without vomiting within 30 minutes

    Measured: From PACU discharge until event occurs, assessed up to 48 hours postoperatively

  16. Time to first bowel movement

    Definition: Hours from surgery end to first flatus or defecation reported by patient

    Measured: From surgery completion until event occurs, assessed up to 7 days postoperatively

  17. Postoperative length of stay

    Definition: Days from surgery end to hospital discharge (excluding preoperative days)

    Measured: From surgery completion until discharge, assessed up to 14 days postoperatively

  18. Delayed local anesthetic-related complications (24-72 hours)

    Definition: Complications manifesting 24-72 hours postoperatively

    Subcategories:

    1.Wound Complications:

    1. Infection: CDC criteria (purulent drainage + ≥1: erythema, pain, swelling)
    2. Hematoma: Ultrasound-confirmed collection >5 mL + hemoglobin drop ≥1 g/dL
    3. Neurological Injury 2.Persistent deficit: Sensory/motor dysfunction beyond 72 hours Confirmed by: Day 3: Nerve conduction studies (amplitude reduction >50%). Day 7: EMG if symptoms persist

    Assessment Schedule:

    Fixed timepoints: 24h (Day 1), 48h (Day 2), 72h (Day 3) at 08:00 AM Symptom-driven: Any clinical suspicion triggers immediate evaluation

    Measured: Any clinical suspicion triggers immediate evaluation from 24 hours (Day 1) through 72 hours (Day 3) postoperatively

Timeline

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

  1. First posted12 Sep 2025
  2. Study start20 Sep 2025
  3. Primary completion28 Feb 2026
  4. Study completion3 Mar 2026

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
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
204 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07171125
Sponsor's protocol ID
M20250040
Status last verified
Jun 2026
First submitted
27 Aug 2025
Last updated
1 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared publicly due to local data protection regulations, but anonymized aggregate results will be published.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Liposomal bupivacaine (local infiltration) and ropivacaine (local infiltration) in people with Postoperative Acute Pain and Lumbar Degenerative Diseases, run by Min Li 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 3 inclusion and 8 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: finished, as of the sponsor's last update on 1 Jul 2026. 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. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total opioid consumption within 72 hours postoperatively (converted to morphine milligram equivalents, MME) (time frame: 72 hours postoperative). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 1 Jul 2026.

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