Trial Outcomes & Findings for Use of On-Q Pump for Pain Post C-Section (NCT NCT02579629)

NCT ID: NCT02579629

Last Updated: 2020-10-14

Results Overview

The intensity of pain during cough will be measured using a visual analogue pain scale (VAPS). Subjects will be instructed to indicate the intensity of the pain by marking on a 100-mm vertical lines with terms describing the extremes of pain intensity. The lines are anchored with "no pain" at the bottom and "worst imaginable pain" at the top. Pain scores range from 0-100, so the change in pain score (post- minus pre-) can theoretically range from -100 to 100. A negative score indicates an improvement in pain. Higher scores indicate higher intensities of pain.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

64 participants

Primary outcome timeframe

2 hours post baseline, 6, 12, 24, 48, 72 hours post baseline

Results posted on

2020-10-14

Participant Flow

Participants were enrolled between July 2015 and July 2019.

Participant milestones

Participant milestones
Measure
Ropivacaine 0.1%
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Overall Study
STARTED
22
20
22
Overall Study
COMPLETED
20
19
20
Overall Study
NOT COMPLETED
2
1
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Ropivacaine 0.1%
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Overall Study
Withdrawal by Subject
0
1
0
Overall Study
Screen Failure
2
0
2

Baseline Characteristics

Use of On-Q Pump for Pain Post C-Section

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Total
n=59 Participants
Total of all reporting groups
Age, Continuous
29.3 years
STANDARD_DEVIATION 4.7 • n=5 Participants
32.1 years
STANDARD_DEVIATION 5.1 • n=7 Participants
31.9 years
STANDARD_DEVIATION 5.7 • n=5 Participants
31.2 years
STANDARD_DEVIATION 5.2 • n=4 Participants
Sex: Female, Male
Female
20 Participants
n=5 Participants
19 Participants
n=7 Participants
20 Participants
n=5 Participants
59 Participants
n=4 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
3 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
19 Participants
n=5 Participants
18 Participants
n=7 Participants
19 Participants
n=5 Participants
56 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
3 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
4 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
15 Participants
n=5 Participants
13 Participants
n=7 Participants
14 Participants
n=5 Participants
42 Participants
n=4 Participants
Race (NIH/OMB)
White
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
10 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
3 Participants
n=4 Participants
Region of Enrollment
United States
20 participants
n=5 Participants
19 participants
n=7 Participants
20 participants
n=5 Participants
59 participants
n=4 Participants

PRIMARY outcome

Timeframe: 2 hours post baseline, 6, 12, 24, 48, 72 hours post baseline

Population: The drop of participants at 72 hours reflects patients who were discharged early, prior to the 72 hr Visit. Other missing values occurred when patients could not be located at the scheduled time because they were not in their room.

The intensity of pain during cough will be measured using a visual analogue pain scale (VAPS). Subjects will be instructed to indicate the intensity of the pain by marking on a 100-mm vertical lines with terms describing the extremes of pain intensity. The lines are anchored with "no pain" at the bottom and "worst imaginable pain" at the top. Pain scores range from 0-100, so the change in pain score (post- minus pre-) can theoretically range from -100 to 100. A negative score indicates an improvement in pain. Higher scores indicate higher intensities of pain.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in Pain Scores During Cough From Baseline
Change in score at 72-hours post baseline
6.5 score on a scale
Interval -1.5 to 32.25
0 score on a scale
Interval 0.0 to 20.0
3 score on a scale
Interval -1.5 to 15.0
Change in Pain Scores During Cough From Baseline
Change in score at 2-hours post baseline
4 score on a scale
Interval 0.0 to 15.0
1 score on a scale
Interval -4.5 to 18.5
20.5 score on a scale
Interval 4.75 to 36.25
Change in Pain Scores During Cough From Baseline
Change in score at 6-hours post baseline
10 score on a scale
Interval 4.0 to 27.0
3 score on a scale
Interval -8.0 to 10.0
10.5 score on a scale
Interval 3.75 to 30.75
Change in Pain Scores During Cough From Baseline
Change in score at 12-hours post baseline
14.5 score on a scale
Interval 4.0 to 26.0
2 score on a scale
Interval -4.0 to 13.0
15.5 score on a scale
Interval 9.75 to 41.25
Change in Pain Scores During Cough From Baseline
Change in score at 24-hours post baseline
20 score on a scale
Interval 1.5 to 45.5
27 score on a scale
Interval 0.0 to 36.0
15.5 score on a scale
Interval 9.75 to 41.25
Change in Pain Scores During Cough From Baseline
Change in score at 48-hours post baseline
13 score on a scale
Interval 6.5 to 39.75
2 score on a scale
Interval -2.5 to 26.5
15 score on a scale
Interval -0.5 to 35.75

PRIMARY outcome

Timeframe: Baseline (At zero time, the time of the first dosing using the On-Q catheter), 2, 6, 12, 24, 48, 72 hours post baseline

Population: The drop of participants at 72 hours reflects patients who were discharged early, prior to the 72 hr Visit. Other missing values occurred when patients could not be located at the scheduled time because they were not in their room.

The intensity of pain during 20° straight leg raise will be measured using a visual analogue pain scale (VAPS). Subjects will be instructed to indicate the intensity of the pain by marking on a 100-mm vertical lines with terms describing the extremes of pain intensity. The lines are anchored with "no pain" at the bottom and "worst imaginable pain" at the top. Higher scores indicate higher intensities of pain.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in Pain Scores During 20°Straight Leg Raise
Change in score at 6-hours post baseline
8 score on a scale
Interval 1.0 to 18.0
0 score on a scale
Interval -2.0 to 6.5
5 score on a scale
Interval 0.75 to 19.5
Change in Pain Scores During 20°Straight Leg Raise
Change in score at 2-hours post baseline
4 score on a scale
Interval 1.5 to 12.5
5 score on a scale
Interval 0.0 to 17.5
10.5 score on a scale
Interval 1.75 to 31.0
Change in Pain Scores During 20°Straight Leg Raise
Change in score at 12-hours post baseline
-6.5 score on a scale
Interval -22.5 to 0.0
0 score on a scale
Interval -2.5 to 1.5
-6.5 score on a scale
Interval -28.5 to 0.0
Change in Pain Scores During 20°Straight Leg Raise
Change in score at 24-hours post baseline
9 score on a scale
Interval 0.75 to 23.75
0 score on a scale
Interval 0.0 to 21.25
16 score on a scale
Interval 0.75 to 29.0
Change in Pain Scores During 20°Straight Leg Raise
Change in score at 48-hours post baseline
9.5 score on a scale
Interval 0.75 to 21.25
3 score on a scale
Interval 0.0 to 22.5
17 score on a scale
Interval 0.75 to 27.0
Change in Pain Scores During 20°Straight Leg Raise
Change in score at 72-hours post baseline
1 score on a scale
Interval -3.0 to 8.25
3 score on a scale
Interval 0.0 to 10.0
2.5 score on a scale
Interval 0.0 to 12.0

PRIMARY outcome

Timeframe: 6 weeks, 3 months

Population: The difference reflects the number of patients who were lost to follow up at 6 weeks and 3 months.

Post-operative pain will be measured using a numerical pain scale (NPS). Subjects will be asked to indicate the level of pain with 0 being no pain and 10 being the worst imaginable pain. Higher scores indicate higher intensities of pain. Participants will report intensity of pain at the week 6 and 3 month time points through a telephone call.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=17 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=17 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in Intensity of Pain: Numerical Pain Scale (NPS) From Baseline
Change at 3 months post intervention
0 units on a scale
Interval 0.0 to 3.0
0 units on a scale
Interval 0.0 to 0.0
0 units on a scale
Interval 0.0 to 0.75
Change in Intensity of Pain: Numerical Pain Scale (NPS) From Baseline
Change at 6 weeks post intervention
3 units on a scale
Interval 0.0 to 5.0
2 units on a scale
Interval 0.0 to 4.0
5 units on a scale
Interval 2.5 to 6.5

PRIMARY outcome

Timeframe: 24 hours post-intervention, 48 hrs, and 72hr post-intervention.

Population: The differences in the number of participants reflect patients who were discharged earlier than 72 hours and patients whose assessments could not be completed because they were not available (out of the room, etc). All 0 values are real reports of "no pain", which was the median score for Outcome 3. None of them represent missing values or NA.

Incisional pain will be measured using a visual analogue pain scale (VAPS). Subjects will be instructed to indicate the intensity of the pain by marking on a 100-mm vertical lines with terms describing the extremes of pain intensity. The lines are anchored with "no pain" at the bottom and "worst imaginable pain" at the top. Pain scores range from 0-100, so the change in pain score (post- minus pre-) can theoretically range from -100 to 100. A negative score indicates an improvement in pain. Higher scores indicate higher intensities of pain. Participants will report intensity of pain 2hrs post intervention, 6hr, 12hr, 24hr, 48hr, and 72hr post-intervention.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in Intensity of Pain: VAPS From Baseline
Change in score at 24 hours post intervention
0 units on a scale
Interval 0.0 to 5.75
0 units on a scale
Interval 0.0 to 13.0
0 units on a scale
Interval 0.0 to 44.5
Change in Intensity of Pain: VAPS From Baseline
Change in score at 48 hours post intervention
0 units on a scale
Interval 0.0 to 11.25
0 units on a scale
Interval 0.0 to 13.5
0 units on a scale
Interval 0.0 to 12.28
Change in Intensity of Pain: VAPS From Baseline
Change in score at 72 hours post intervention
0 units on a scale
Interval 0.0 to 0.0
0 units on a scale
Interval 0.0 to 0.0
0 units on a scale
Interval 0.0 to 0.0

PRIMARY outcome

Timeframe: 2 hours post-intervention, 6 hours, 12 hours, 24 hours, 72 hours, 6 weeks, 3 months post-intervention

Population: The differences in number of participants reflect patients who were discharged earlier than 72 hours and patients whose assessments could not be completed because they were not available (out of the room, etc. )

Pain with movement will be assessed using the self-report mini-McGill pain questionnaire, consisting of the first 15 questions of the McGill questionnaire, scores 0-3 points for each. It can theoretically range from 0 to 45, with 45 correlating with worse pain.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in McGill Pain Questionnaire Score From Baseline
2 hrs post Baseline
1.5 score on a scale
Interval 0.0 to 4.0
2 score on a scale
Interval 0.0 to 3.5
2 score on a scale
Interval 1.0 to 3.5
Change in McGill Pain Questionnaire Score From Baseline
6 hrs post Baseline
2 score on a scale
Interval 1.0 to 4.5
2 score on a scale
Interval 1.0 to 2.5
2 score on a scale
Interval 0.0 to 4.25
Change in McGill Pain Questionnaire Score From Baseline
12 hrs post Baseline
1 score on a scale
Interval 0.0 to 3.0
1 score on a scale
Interval 0.0 to 2.0
2 score on a scale
Interval 1.0 to 3.5
Change in McGill Pain Questionnaire Score From Baseline
24 hrs post Baseline
1.5 score on a scale
Interval 1.0 to 5.25
3 score on a scale
Interval 1.0 to 5.0
2 score on a scale
Interval 1.0 to 5.0
Change in McGill Pain Questionnaire Score From Baseline
48 hrs post Baseline
2.5 score on a scale
Interval 1.0 to 4.25
3 score on a scale
Interval 0.0 to 6.0
2 score on a scale
Interval 1.0 to 3.0
Change in McGill Pain Questionnaire Score From Baseline
72 hrs post Baseline
2 score on a scale
Interval 1.0 to 3.0
3 score on a scale
Interval 0.0 to 4.5
1 score on a scale
Interval 0.0 to 2.5
Change in McGill Pain Questionnaire Score From Baseline
6 weeks post Baseline
0 score on a scale
Interval 0.0 to 1.0
0 score on a scale
Interval 0.0 to 1.5
0 score on a scale
Interval 0.0 to 1.0
Change in McGill Pain Questionnaire Score From Baseline
3 months post Baseline
0 score on a scale
Interval 0.0 to 1.0
0 score on a scale
Interval 0.0 to 0.0
0 score on a scale
Interval 0.0 to 1.0

PRIMARY outcome

Timeframe: 2 hours post-intervention, 6 hours, 12 hours, 24 hours, 48 hous, 72 hours post baseline

Population: The differences in number of participants reflect patients who were discharged earlier than 72 hours and patients whose assessments could not be completed because they were not available (out of the room, etc. )

The intensity of pain at rest will be measured using a visual analogue pain scale (VAPS). Subjects will be instructed to indicate the intensity of the pain by marking on a 100-mm vertical lines with terms describing the extremes of pain intensity. The lines are anchored with "no pain" at the bottom and "worst imaginable pain" at the top. Higher scores indicate higher intensities of pain.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in Pain Scores at Rest From Baseline
Change in score at 2-hours post baseline
5 score on a scale
Interval 0.0 to 23.5
0 score on a scale
Interval -4.5 to 9.0
7 score on a scale
Interval 0.0 to 27.75
Change in Pain Scores at Rest From Baseline
Change in score at 6-hours post baseline
3 score on a scale
Interval 0.0 to 17.0
0 score on a scale
Interval -7.0 to 4.0
5.5 score on a scale
Interval 0.0 to 15.5
Change in Pain Scores at Rest From Baseline
Change in score at 12-hours post baseline
5 score on a scale
Interval 0.0 to 19.25
0 score on a scale
Interval -7.5 to 3.5
1.5 score on a scale
Interval 0.0 to 12.5
Change in Pain Scores at Rest From Baseline
Change in score at 24-hours post baseline
8 score on a scale
Interval 0.0 to 32.75
5.5 score on a scale
Interval -0.75 to 16.75
4.5 score on a scale
Interval -3.25 to 17.75
Change in Pain Scores at Rest From Baseline
Change in score at 48-hours post baseline
4.5 score on a scale
Interval 0.0 to 15.75
3 score on a scale
Interval -4.0 to 13.5
2.5 score on a scale
Interval -5.5 to 22.5
Change in Pain Scores at Rest From Baseline
Change in score at 72-hours post baseline
0 score on a scale
Interval 0.0 to 4.0
0 score on a scale
Interval 0.0 to 7.0
2 score on a scale
Interval -6.25 to 13.5

SECONDARY outcome

Timeframe: Baseline (At zero time, the time of the first dosing using the On-Q catheter), 72 hours post-operatively

The time to dosing with the first rescue medications like, non-steroidal anti-inflammatory drugs and morphine, for breakthrough pain will be noted. A shorter time to dosing indicates an increased intensity of pain. It will be recorded in hours post intervention.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Change in Time From Baseline to First Dose of Rescue Medications
9.05 Hours
Interval 1.38 to 12.94
3.50 Hours
Interval 1.05 to 9.75
2 Hours
Interval 1.38 to 10.6

SECONDARY outcome

Timeframe: In the post-anesthesia care unit (up to 2 hours post-operatively), 72 hours post-operatively

Population: Data was not obtained/recorded by nurses during shift and some patients were not available (out of the room, etc).

Breastfeeding success will be measured using LATCH scores. The LATCH system assigns a numerical score, 0, 1, or 2, to five key components of breastfeeding: "L" is for how well the infant latches onto the breast, "A" is for the amount of audible swallowing noted, "T" is for the mother's nipple type, "C" is for the mother's level of comfort and "H" is for the amount of help the mother needs to hold her infant to the breast. The theoretical range of the Latch score is 0 to 10. Higher scores indicate higher success with breastfeeding.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=7 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=6 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=7 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Breastfeeding Success
2 hours post intervention
10 score on a scale
Interval 8.75 to 10.0
6.5 score on a scale
Interval 5.0 to 7.25
6.5 score on a scale
Interval 6.25 to 6.75
Breastfeeding Success
72 hours post intervention
10 score on a scale
Interval 8.75 to 10.0
10 score on a scale
Interval 9.25 to 10.0
10 score on a scale
Interval 9.25 to 10.0

SECONDARY outcome

Timeframe: 24 hours, 48 hours, 72 hours post intervention

The cesarean section incision and the catheter insertion site will be evaluated. Any catheter or infiltrate-related issues like wound infection and seroma formation will be noted. It will be reported as number of issues. Wounds will be assessed for infection or dehiscence. Clean wound lines with no evidence of infection indicate better healing.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Number of Participants With Catheter or Infiltrate-related Issues at 24, 48 and 72 Hours Post-intervention
24 hours post intervention
0 Participants
0 Participants
0 Participants
Number of Participants With Catheter or Infiltrate-related Issues at 24, 48 and 72 Hours Post-intervention
48 hours post intervention
0 Participants
0 Participants
0 Participants
Number of Participants With Catheter or Infiltrate-related Issues at 24, 48 and 72 Hours Post-intervention
72 hours post intervention
0 Participants
1 Participants
0 Participants

SECONDARY outcome

Timeframe: 6 weeks postintervention, 3 months postintervention

At the 6 week and 3-month follow-up phone calls the participant will be asked about the presence of wound dysesthesia (numbness, tingling, burning, pricking, allodynia, or hyperesthesia), occurrence of infection, dehiscence, and keloid formation.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
3 Months - Infection
0 Participants
0 Participants
0 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
3 Months- Dehiscence
0 Participants
0 Participants
0 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
3 Months- Keloid Formation
0 Participants
0 Participants
0 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
6 Weeks- Wound Dysesthesia
2 Participants
2 Participants
6 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
6 Weeks- Infection
0 Participants
0 Participants
0 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
6 Weeks- Dehiscence
0 Participants
0 Participants
0 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
6 Weeks- Keloid Formation
0 Participants
0 Participants
0 Participants
Number of Patients With Wound Dysesthesia, Infection, Dehiscence and Keloid Formation at 6 Weeks and 3 Months Post-intervention
3 Months- Wound Dysesthesia
1 Participants
2 Participants
3 Participants

SECONDARY outcome

Timeframe: At the time of hospital discharge (average of 3 days)

A cost analysis will occur for the inpatient stay. Costs to be assessed include cost for preparation of the drugs and devices, monitoring/supervision costs based on nursing and physician interventions and cost of days spent in the hospital.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Cost Analysis
27.9 Dollars
Standard Deviation 16.6
26.8 Dollars
Standard Deviation 18.8
31.6 Dollars
Standard Deviation 19.8

SECONDARY outcome

Timeframe: 72 hours post-operatively

Patient satisfaction will be assessed by using the visual analog scale (VAS). The visual analog scale (VAS) for satisfaction is a horizontal line 100mm long. At the beginning and the end, there are two descriptors representing extremes of satisfaction. The subjects will be asked to rate their satisfaction by making a vertical mark on the 100mm line, where, 0= least satisfied and 100=most satisfied. Higher scores indicate higher levels of satisfaction.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=17 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Patient Satisfaction at 72 Hours Post Intervention
60 units on a scale
Standard Deviation 40.15
61.53 units on a scale
Standard Deviation 39.00
48.3 units on a scale
Standard Deviation 35.43

SECONDARY outcome

Timeframe: 24 post-operatively, 72 hours post-operatively

The total dose of non-steroidal anti-inflammatory drugs (NSAIDs) in mg will be recorded for each of the first three post-operative days and after discharge as indicated, along with a cumulative total. Higher doses of NSAIDs usage indicate higher intensities of pain.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Dosing Amount of Non-steroidal Anti-inflammatory Drugs
24 hours post intervention
80 mg
Standard Deviation 246
211 mg
Standard Deviation 645
379 mg
Standard Deviation 899
Dosing Amount of Non-steroidal Anti-inflammatory Drugs
72 hours post intervention
2040 mg
Standard Deviation 799
1726 mg
Standard Deviation 1075
1095 mg
Standard Deviation 1228

SECONDARY outcome

Timeframe: 24 post-operatively, 72 hours post-operatively

The amount of opioid use will be quantified in terms of morphine equivalents given in mg both by post -operative day and with a cumulative total. Higher amounts of opioid use indicates higher degrees of pain.

Outcome measures

Outcome measures
Measure
Ropivacaine 0.1%
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.1% ropivacaine followed by an infusion of 8ml/hr of 0.1% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Ropivacaine 0.2%
n=19 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml of 0.2% ropivacaine followed by an infusion of 8ml/hr of 0.2% ropivacaine using the On-Q® elastomeric pump for 3 days after the cesarean section.
Normal Saline
n=20 Participants
Subjects undergoing cesarean sections will receive a bolus dose of 8ml normal saline followed by an infusion of 8ml/hr of normal saline using the On-Q® elastomeric pump for 3 days after the cesarean section.
Amount of Opioid Use
24 hours post intervention
0.35 mg
Standard Deviation 1.77
6.45 mg
Standard Deviation 27.50
1.65 mg
Standard Deviation 5.28
Amount of Opioid Use
72 hours post intervention
24.98 mg
Standard Deviation 37.81
54.28 mg
Standard Deviation 164.3
31.25 mg
Standard Deviation 41.33

Adverse Events

Ropivacaine 0.1%

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

Ropivacaine 0.2%

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

Normal Saline

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

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Katherine Egan

Emory University

Phone: 404-727-8463

Results disclosure agreements

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