Cranial Blocks for Postoperative Anesthesia

NCT ID: NCT04749797

Last Updated: 2023-09-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE4

Total Enrollment

11 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-02

Study Completion Date

2021-07-20

Brief Summary

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This study compares the standard of care to the standard of care plus the administration of bupivacaine or liposomal bupivacaine in patients receiving craniotomies.

Detailed Description

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Objective: To assess the effectiveness of analgesia by scalp nerve block with various agents in the first 72 hours following elective craniotomy.

The investigators will employ a randomized, single-blinded, prospective study design. Participants will be randomized 1:1:1 into one of three treatment groups: Bupivacaine, Liposomal Bupivacaine, and Saline.

Conditions

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Craniotomy Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized to one of three groups: saline, bupivacaine, liposomal bupivacaine
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
On the morning of the procedure, participants will be assigned sequentially to the lowest unassigned randomization number. The surgeon performing the procedure and operating room staff will not be blinded to the intervention, since they will see whether the patient is receiving liposomal bupivacaine, bupivacaine or saline. However, all providers obtaining post-operative data from the patients will be blinded as to which treatment the patient received, in addition to the patient themselves.

Study Groups

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Saline group

The surgeon will administer injectable saline as a cranial block. The supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, postauricular lesser and greater occipital nerve branches on the ipsilateral side of the operation will be blocked with 5-10 cc of solution (with a maximum of 60 cc at all sites) by needle infiltration. This process generally takes 1-2 minutes. Following this, the general anesthesia is lightened and the patient is extubated in usual fashion.

Group Type PLACEBO_COMPARATOR

Saline

Intervention Type DRUG

Used as cranial block for craniotomy surgery

Bupivacaine

The surgeon will administer bupivacaine as a cranial block. The supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, postauricular lesser and greater occipital nerve branches on the ipsilateral side of the operation will be blocked with 5-10 cc of solution (with a maximum of 60 cc at all sites) by needle infiltration. This process generally takes 1-2 minutes. Following this, the general anesthesia is lightened and the patient is extubated in usual fashion.

Group Type ACTIVE_COMPARATOR

Bupivacaine Injection

Intervention Type DRUG

Used as cranial block for craniotomy surgery

Liposomal Bupivacaine

The surgeon will administer Exparel (liposomal bupivacine) as a cranial block. 20 mL of Exparel will be diluted with saline to constitute 60 mL total. The supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, postauricular lesser and greater occipital nerve branches on the ipsilateral side of the operation will be blocked with 5-10 cc of solution (with a maximum of 60 cc at all sites) by needle infiltration. This process generally takes 1-2 minutes. Following this, the general anesthesia is lightened and the patient is extubated in usual fashion.

Group Type EXPERIMENTAL

Liposomal bupivacaine

Intervention Type DRUG

Used as cranial block for craniotomy surgery

Interventions

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Liposomal bupivacaine

Used as cranial block for craniotomy surgery

Intervention Type DRUG

Bupivacaine Injection

Used as cranial block for craniotomy surgery

Intervention Type DRUG

Saline

Used as cranial block for craniotomy surgery

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* ≥18 years of age
* Need for elective supratentorial craniotomy
* Preoperative GCS \> 13

Exclusion Criteria

* Preoperative GCS ≤ 13
* Child (\<18 years of age)
* Inability to understand or use the visual analog scale (VAS)
* Proven or suspected allergy to local anesthetics
* Craniotomy incision extending beyond the field of the block
* Patients chronically (more than 2 wk) treated with narcotic medications
* Previous scalp incision
* Bilateral craniotomies
* Allergies to local anesthetics
* GCS verbal score \< 4 after extubation
* Patients whose surgeries extend past 6 hours (will be placed on standard of care and removed from study)
* Patients currently on ergot-type oxytoxic drugs, MAOIs, or certain antidepressants
* Lactating Mothers
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Timothy Lucas, MD, PHD, MHCI

Primary Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Timothy H Lucas, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

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University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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834603

Identifier Type: -

Identifier Source: org_study_id

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