Transversus Abdominis Plane Block in Microsurgical Breast Recon w/Abdominal Free Flap in Breast CA

NCT ID: NCT02601027

Last Updated: 2021-09-23

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2021-06-30

Brief Summary

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The primary objective is to determine if pre-operative transversus abdominis plane (TAP) nerve blocks by continued infusion of local anesthetic post-operatively affects post-operative narcotic usage, as compared to a placebo TAP block, after breast reconstruction surgery.

Detailed Description

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Primary Objective: The primary objective is to determine if pre-operative transversus abdominis plane (TAP) blocks with continued infusion of local anesthetic post-operatively affect post-operative narcotic usage as compared to a placebo TAP block.

Secondary Objectives:

* Determine if pre-operative TAP blocks with continued infusion of local anesthetic post-operatively affect post-operative pain scores as compared to a placebo TAP block.
* Determine if pre-operative TAP blocks with continued infusion of local anesthetic post-operatively affect anti-emetic usage as compared to a placebo TAP block.
* Determine if pre-operative TAP blocks with continued infusion of local anesthetic post-operatively affect time to ambulation post-operatively as compared to a placebo TAP block.
* Determine if pre-operative TAP blocks with continued infusion of local anesthetic post-operatively affect time to first bowel movement as compared to a placebo TAP block.
* Determine if pre-operative TAP blocks with continued infusion of local anesthetic post-operatively affect patient-reported quality of life as compared to a placebo TAP block.

Conditions

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Breast - Female

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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0.125% Bupivacaine

0.125% bupivacaine infusion via transversus abdominis plane (TAP) catheter

Group Type EXPERIMENTAL

Transversus Abdominis Plane (TAP) block

Intervention Type PROCEDURE

Nimbus Infusion Pump IV Administration

Intervention Type DEVICE

Bupivacaine infusion

Intervention Type DRUG

Acetominophen

Intervention Type DRUG

Hydromorphone

Intervention Type DRUG

Oxycodone

Intervention Type DRUG

Ondansetron

Intervention Type DRUG

Placebo

Saline infusion (sham) via transversus abdominis plane (TAP) catheter.

Group Type PLACEBO_COMPARATOR

Transversus Abdominis Plane (TAP) block

Intervention Type PROCEDURE

Nimbus Infusion Pump IV Administration

Intervention Type DEVICE

Acetominophen

Intervention Type DRUG

Hydromorphone

Intervention Type DRUG

Oxycodone

Intervention Type DRUG

Ondansetron

Intervention Type DRUG

Interventions

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Transversus Abdominis Plane (TAP) block

Intervention Type PROCEDURE

Nimbus Infusion Pump IV Administration

Intervention Type DEVICE

Bupivacaine infusion

Intervention Type DRUG

Acetominophen

Intervention Type DRUG

Hydromorphone

Intervention Type DRUG

Oxycodone

Intervention Type DRUG

Ondansetron

Intervention Type DRUG

Other Intervention Names

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Exparel Marcaine Marcaine Spinal Sensorcaine Sensorcaine-MPF Sensorcaine-MPF Spinal ReadySharp bupivacaine P-Care M Tylenol Dilaudid Dilaudid-HP Exalgo Oxycontin Xtampza ER Oxaydo Roxicodone Zofran Zofran ODT Zuplenz

Eligibility Criteria

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Inclusion Criteria

* Prior diagnosis or presumed diagnosis of breast cancer or undergoing prophylactic treatment.
* Greater than 18 years old.
* Female.
* Undergoing microsurgical breast reconstruction with abdominal free flap.
* Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

* True allergy to local anesthetics or opioids.
* History of addiction to narcotics within the last 24 months
* History of chronic pain on opioids within the last 24 months.
* Specific mental health issues such as schizophrenia or bipolar disorder.
* Patients who are pregnant.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Gordon Kwanlyp Lee

Professor of Surgery (Plastic and Reconstructive Surgery)

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gordon K Lee, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Stanford University Medical Center

Stanford, California, United States

Site Status

Countries

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United States

References

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Mundy LR, Homa K, Klassen AF, Pusic AL, Kerrigan CL. Breast Cancer and Reconstruction: Normative Data for Interpreting the BREAST-Q. Plast Reconstr Surg. 2017 May;139(5):1046e-1055e. doi: 10.1097/PRS.0000000000003241.

Reference Type BACKGROUND
PMID: 28445351 (View on PubMed)

Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg. 2009 Aug;124(2):345-353. doi: 10.1097/PRS.0b013e3181aee807.

Reference Type BACKGROUND
PMID: 19644246 (View on PubMed)

Voineskos SH, Klassen AF, Cano SJ, Pusic AL, Gibbons CJ. Giving Meaning to Differences in BREAST-Q Scores: Minimal Important Difference for Breast Reconstruction Patients. Plast Reconstr Surg. 2020 Jan;145(1):11e-20e. doi: 10.1097/PRS.0000000000006317.

Reference Type BACKGROUND
PMID: 31577663 (View on PubMed)

Kwong JW, Tijerina JD, Choi S, Shakir A, Nguyen DH, Nazerali RS, Lee GK. Randomized Double-Blinded, Placebo-Controlled Trial: Transversus Abdominis Plane (TAP) Blocks in Breast Cancer Patients Undergoing Reconstruction with Abdominal Free Flap. Annual Meeting of the California Society of Plastic Surgeons. San Diego, California. May 19, 2018.

Reference Type RESULT

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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BRS0058

Identifier Type: OTHER

Identifier Source: secondary_id

IRB-34315

Identifier Type: -

Identifier Source: org_study_id

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