The purpose of this study is to determine whether the CollaRx Bupivacaine implant is safe and effective in reducing the amount of narcotic pain medication needed to control pain during the first 24 hours after abdominal hysterectomy surgery.
Hysterectomy is the second most common surgery among women in the United States (US). According to the National Center for Health Statistics, there were 617,000 hysterectomies performed in the US in 2004. Effective postoperative pain management after hysterectomy is important in ensuring that surgical subjects have a smooth and successful recovery after their operation. Morphine and other narcotic pain medications are often used to help control pain after hysterectomy, but the large quantities required can lead to fatigue, nausea and vomiting, as well as the inability to walk around much because of drowsiness. Reducing narcotic pain medication use can reduce these negative side effects. Bupivacaine is a local anesthetic (pain medicine) that has an established safety profile. Collagen is a protein that is found in all mammals. The CollaRx Bupivacaine implant is a thin flat sponge made out of collagen that comes from cow tendons and contains bupivacaine. When inserted into a surgical site, the collagen breaks down and bupivacaine is released at the site but very little is absorbed into the blood stream. The high levels of bupivacaine at the surgical site may result in less pain for several days after surgery. This study will compare the amount of narcotic pain medication required after surgery in patients who receive the CollaRx Bupivacaine implant, a plain collagen implant or no implant at all.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
54
The bupivacaine sponge contains 70 mg Type I collagen and 50 mg bupivacaine hydrochloride. A total of 3 sponges will be implanted during surgery; one sponge divided between areas in the vault, one sponge divided and placed across the incision in the peritoneum and the final sponge divided and placed between the sheath and skin around the incision.
The placebo sponge contains 70 mg Type I collagen. A total of 3 sponges will be implanted during surgery; one sponge divided between areas in the vault, one sponge divided and placed across the incision in the peritoneum and the final sponge divided and placed between the sheath and skin around the incision.
Forsyth Medical Centre - OB Anesthesia
Winston-Salem, North Carolina, United States
Total Use of Opioid Rescue Analgesia
Total use of opioid rescue analgesia (mg equivalent) -higher score means more analgesia was needed and worse outcome
Time frame: 0 to 24 hours postoperatively
Total Use of Opioid Rescue Analgesia
Total use of opioid rescue analgesia (mg equivalent) -higher score means more analgesia was needed and worse outcome
Time frame: 0 to 48 hours postoperatively
Total Use of Opioid Rescue Analgesia
Total use of opioid rescue analgesia (mg equivalent) -higher score means more analgesia was needed and worse outcome
Time frame: 0 to 72 hours postoperatively
Pain Intensity Rating on a Visual Analog Scale (at Rest)
Pain intensity rating on a Visual Analog Scale (at rest). Lowest score possible is "0" with the highest score possible being "100". Higher number means more pain reported.
Time frame: At 1, 1.5, 2, 3, 6, 9, 12, 18, 24, 36, 48 and 72 hours post operatively
Time to First Use of Opioid Rescue Analgesia
Time to first use of opioid rescue analgesia - lower number means worse outcome
Time frame: Actual time assessed during post operative period
Pain Intensity Rating on a Visual Analog Scale (After Cough)
Pain intensity rating on a Visual Analog Scale (after cough). Lowest score possible is "0" with the highest score possible being "100". Higher number means more pain reported.
Time frame: At 1, 1.5, 2, 3, 6, 9, 12, 18, 24, 36, 48 and 72 hours post operatively
Pain Intensity Rating on a 4-point Likert Scale (at Rest)
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For the 4-point categorical scale assessment, patients measured their pain intensity at rest using a numerical scale where: 0 = "none," 1 = "mild," 2 = "moderate" and 3 = "severe."
Time frame: At 1, 1.5, 2, 3, 6, 9, 12, 18, 24, 36, 48 and 72 hours post operatively
Pain Intensity Rating on a 4-point Likert Scale (After Cough)
For the 4-point categorical scale assessment, patients measured their pain intensity after aggravated movement (cough) using a numerical scale where: 0 = "none," 1 = "mild," 2 = "moderate" and 3 = "severe."
Time frame: At 1, 1.5, 2, 3, 6, 9, 12, 18, 24, 36, 48 and 72 hours post operatively