Trial Outcomes & Findings for Effect of Paracervical Block on Post Operative Pain in Laparoscopic Gynecologic Surgery (NCT NCT01534416)

NCT ID: NCT01534416

Last Updated: 2017-12-20

Results Overview

Unplanned hospital admissions and the hospital admissions at the request of the patients for pain management

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

132 participants

Primary outcome timeframe

Four hours after conclusion of surgery

Results posted on

2017-12-20

Participant Flow

Patients undergoing laparoscopic surgery for benign indications were enrolled between 2011 and 2013

Participant milestones

Participant milestones
Measure
Bupivacaine
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Overall Study
STARTED
68
64
Overall Study
COMPLETED
68
64
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Effect of Paracervical Block on Post Operative Pain in Laparoscopic Gynecologic Surgery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Bupivacaine
n=68 Participants
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=64 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Total
n=132 Participants
Total of all reporting groups
Age, Continuous
48.4 years
STANDARD_DEVIATION 9.2 • n=5 Participants
47.8 years
STANDARD_DEVIATION 9.3 • n=7 Participants
48.1 years
STANDARD_DEVIATION 9.2 • n=5 Participants
Sex: Female, Male
Female
68 Participants
n=5 Participants
64 Participants
n=7 Participants
132 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
White
36 Participants
n=5 Participants
28 Participants
n=7 Participants
64 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
12 Participants
n=5 Participants
20 Participants
n=7 Participants
32 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
13 Participants
n=5 Participants
10 Participants
n=7 Participants
23 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Body Mass Index
27.2 kg/m^2
STANDARD_DEVIATION 5.7 • n=5 Participants
29.1 kg/m^2
STANDARD_DEVIATION 6.9 • n=7 Participants
28.1 kg/m^2
STANDARD_DEVIATION 6.4 • n=5 Participants
Parity
0
21 Participants
n=5 Participants
38 Participants
n=7 Participants
59 Participants
n=5 Participants
Parity
1
10 Participants
n=5 Participants
10 Participants
n=7 Participants
20 Participants
n=5 Participants
Parity
2
22 Participants
n=5 Participants
19 Participants
n=7 Participants
41 Participants
n=5 Participants
Parity
≥3
15 Participants
n=5 Participants
11 Participants
n=7 Participants
26 Participants
n=5 Participants
Surgical Indication
Fibroids
7 Participants
n=5 Participants
9 Participants
n=7 Participants
16 Participants
n=5 Participants
Surgical Indication
Bleeding
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Surgical Indication
Prolapse
14 Participants
n=5 Participants
8 Participants
n=7 Participants
22 Participants
n=5 Participants
Surgical Indication
Pain
4 Participants
n=5 Participants
1 Participants
n=7 Participants
5 Participants
n=5 Participants
Surgical Indication
Other
0 Participants
n=5 Participants
3 Participants
n=7 Participants
3 Participants
n=5 Participants
Surgical Indication
Fibroids & bleeding
19 Participants
n=5 Participants
14 Participants
n=7 Participants
33 Participants
n=5 Participants
Surgical Indication
Fibroids, bleeding & pain
18 Participants
n=5 Participants
23 Participants
n=7 Participants
41 Participants
n=5 Participants
Surgical Indication
Bleeding & pain
4 Participants
n=5 Participants
5 Participants
n=7 Participants
9 Participants
n=5 Participants
Uterine Size
13.7 weeks
STANDARD_DEVIATION 5.5 • n=5 Participants
14.2 weeks
STANDARD_DEVIATION 4.6 • n=7 Participants
14.0 weeks
STANDARD_DEVIATION 5.1 • n=5 Participants
Preoperative Hematocrit
36.8 % of cells
STANDARD_DEVIATION 4.0 • n=5 Participants
36.6 % of cells
STANDARD_DEVIATION 4.2 • n=7 Participants
36.7 % of cells
STANDARD_DEVIATION 4.1 • n=5 Participants
Admission Planned
5 admissions
n=5 Participants
1 admissions
n=7 Participants
6 admissions
n=5 Participants

PRIMARY outcome

Timeframe: Four hours after conclusion of surgery

Unplanned hospital admissions and the hospital admissions at the request of the patients for pain management

Outcome measures

Outcome measures
Measure
Bupivacaine
n=68 Participants
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=64 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Saline Group
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision who were admitted for pain management. participants in the Saline arm who requested admission specifically for pain management.
Saline Discharged Participants
Subjects who received saline and discharged after surgery. Participants in the Saline arm who were discharged after procedure and not admitted.
Number of Participants With Hospital Admission for Postoperative Pain Control
Unplanned admission
23 Participants
17 Participants
Number of Participants With Hospital Admission for Postoperative Pain Control
Unplanned admission for pain
10 Participants
11 Participants

SECONDARY outcome

Timeframe: 1and 2 hour postoperatively

Population: This doesn't include hospitalization for reasons other than pain management.

Postoperative pain levels assessed using the visual analogue pain scale. This scale pairs faces with numbers 1-10, with 1 being no pain and 10 being extreme pain. In the PACU pain assessed using this scale by the nursing staff.

Outcome measures

Outcome measures
Measure
Bupivacaine
n=10 Participants
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=40 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Saline Group
n=11 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision who were admitted for pain management. participants in the Saline arm who requested admission specifically for pain management.
Saline Discharged Participants
n=46 Participants
Subjects who received saline and discharged after surgery. Participants in the Saline arm who were discharged after procedure and not admitted.
Postoperative Pain Score
1 hour postoperative
4.7 units on a scale
Standard Deviation 2.9
3.9 units on a scale
Standard Deviation 2.2
5.1 units on a scale
Standard Deviation 2.0
4.5 units on a scale
Standard Deviation 2.4
Postoperative Pain Score
2 hours postoperative
4.3 units on a scale
Standard Deviation 2.5
2.7 units on a scale
Standard Deviation 1.8
4.5 units on a scale
Standard Deviation 2.4
3.8 units on a scale
Standard Deviation 2.3

SECONDARY outcome

Timeframe: 1, 2, 4 hour postoperatively, Day 1 post operatively, Day 2 postoperative

Population: Only those subjects with pain analyzed

Postoperative pain levels assessed using the visual analogue pain scale. This scale pairs faces with numbers 1-10, with 1 being no pain and 10 being extreme pain. In the PACU pain assessed using this scale by the nursing staff. On postoperative days 1 and 2 the subjects self-reported their pain level.

Outcome measures

Outcome measures
Measure
Bupivacaine
n=64 Participants
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=59 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Saline Group
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision who were admitted for pain management. participants in the Saline arm who requested admission specifically for pain management.
Saline Discharged Participants
Subjects who received saline and discharged after surgery. Participants in the Saline arm who were discharged after procedure and not admitted.
Postoperative Pain Score
Day 2 postoperative
3.16 units on a scale
Standard Deviation 2.34
3.37 units on a scale
Standard Deviation 2.39
Postoperative Pain Score
1 hour postoperative
4.30 units on a scale
Standard Deviation 2.55
4.69 units on a scale
Standard Deviation 2.29
Postoperative Pain Score
2 hours postoperative
3.37 units on a scale
Standard Deviation 2.19
4.01 units on a scale
Standard Deviation 2.32
Postoperative Pain Score
4 hours postoperative
3.83 units on a scale
Standard Deviation 2.57
4.35 units on a scale
Standard Deviation 2.43
Postoperative Pain Score
Day 1 postoperative
3.80 units on a scale
Standard Deviation 2.53
4.35 units on a scale
Standard Deviation 2.14

SECONDARY outcome

Timeframe: Postoperative days 0-10

Population: missing data from 5 participants in Bupivacaine Arm and 4 in Saline Arm

Numbers of Patients Using Pain Medication on Postoperative Days 1-10. The subjects recorded at home the type and amount of pain medication they use for 10 days postoperatively.

Outcome measures

Outcome measures
Measure
Bupivacaine
n=63 Participants
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=60 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Saline Group
n=63 Participants
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision who were admitted for pain management. participants in the Saline arm who requested admission specifically for pain management.
Saline Discharged Participants
n=60 Participants
Subjects who received saline and discharged after surgery. Participants in the Saline arm who were discharged after procedure and not admitted.
Postoperative Day Pain Medication Use
Postoperative Day 1
52 participants
52 participants
17 participants
10 participants
Postoperative Day Pain Medication Use
Postoperative Day 2
43 participants
39 participants
24 participants
18 participants
Postoperative Day Pain Medication Use
Postoperative Day 3
28 participants
33 participants
29 participants
22 participants
Postoperative Day Pain Medication Use
Postoperative Day 4
19 participants
26 participants
28 participants
26 participants
Postoperative Day Pain Medication Use
Postoperative Day 5
13 participants
15 participants
19 participants
28 participants
Postoperative Day Pain Medication Use
Postoperative Day 6
12 participants
13 participants
15 participants
24 participants
Postoperative Day Pain Medication Use
Postoperative Day 7
5 participants
11 participants
16 participants
16 participants
Postoperative Day Pain Medication Use
Postoperative Day 8
3 participants
10 participants
12 participants
12 participants
Postoperative Day Pain Medication Use
Postoperative Day 9
2 participants
6 participants
9 participants
11 participants
Postoperative Day Pain Medication Use
Postoperative Day 10
3 participants
7 participants
9 participants
10 participants

Adverse Events

Bupivacaine

Serious events: 1 serious events
Other events: 17 other events
Deaths: 0 deaths

Saline

Serious events: 0 serious events
Other events: 16 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Bupivacaine
n=68 participants at risk
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=64 participants at risk
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Renal and urinary disorders
Stress Incontinence
1.5%
1/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
0.00%
0/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death

Other adverse events

Other adverse events
Measure
Bupivacaine
n=68 participants at risk
Subjects received a 20mL paracervical injection of 0.25% bupivacaine with 1:200000 units epinephrine prior to surgical incision.
Saline
n=64 participants at risk
Subjects injected paracervically with 10 ml of normal saline prior to surgical incision.
Renal and urinary disorders
Urinary Tract Infection
0.00%
0/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
4.7%
3/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Injury, poisoning and procedural complications
Incisional Infection
5.9%
4/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
6.2%
4/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Renal and urinary disorders
Urinary Retention
8.8%
6/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
9.4%
6/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Injury, poisoning and procedural complications
Small Bowel Mesenteric Hematoma
0.00%
0/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
1.6%
1/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Injury, poisoning and procedural complications
Skin laceration
1.5%
1/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
0.00%
0/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Reproductive system and breast disorders
Cervical infection
2.9%
2/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
1.6%
1/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Injury, poisoning and procedural complications
Retropubic hematoma
1.5%
1/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
1.6%
1/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
Injury, poisoning and procedural complications
Bladder performation
1.5%
1/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
0.00%
0/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
General disorders
Seizure
1.5%
1/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
0.00%
0/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
General disorders
Emergency Room Visit
1.5%
1/68 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death
0.00%
0/64 • Complications were noted up to 6 weeks after surgery using the Clavien-Dindo Classification system.
Grade I Any deviation from normal postoperative course without need for pharmacological treatment or surgical, endoscopic, \& radiological interventions II Require pharmacological treatment with drug other than such allowed for Grade I complications III Require surgical, endoscopic or radiological intervention IIIa Intervention not under general anaesthesia IIIb Intervention under general anaesthesia IV Life-threatening complication IVa Single organ IVb Multiorgan V Death

Additional Information

Dr. Rachel L. Barr Grzesh

Icahn School of Medicine at Mount Sinai

Phone: 212-241-2995

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place