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 herniorrhaphy.
Inguinal herniorrhaphy is a common surgery; and common surgical methods used include laparoscopic and open placement of synthetic mesh. The use of synthetic mesh can greatly reduce the risk of hernia recurrence regardless of the method used for its placement. Managing postoperative pain and preventing morbidity after open mesh herniorrhaphy remain considerable medical challenges. 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 either the CollaRx Bupivacaine implant or a plain collagen sponge.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
53
collagen; Bupivacaine hydrocholoride
collagen
Advanced Clinical Research Institute
Anaheim, California, United States
Total Use of Opioid Rescue Analgesia Over 0 to 24 Hours
Total Use of Opioid Rescue Analgesia (mg) Over 0 to 24 Hour - number count - higher score means worse outcome
Time frame: 0 to 24 hours postoperatively
Total Use of Opioid Rescue Analgesia Over 0 to 48 Hours
Number count. Higher score means worse outcome
Time frame: 0 to 48 hours postoperatively
Total Use of Opioid Rescue Analgesia Over 0 to 72 Hours
Number count - higher score means worse outcome
Time frame: 0 to 72 hours postoperatively
Summed Pain Intensity VAS Scores (VAS at Rest and After Cough)
Summed pain intensity (SPI) (VAS at rest and after cough): - For the VAS assessment, patients measured their pain intensity at rest and after aggravated movement (cough) using a horizontal 100-mm VAS scale labeled as follows: No Pain (0 mm) as the left anchor and Worst Pain Imaginable (100 mm) as the right anchor. Each timepoint consist of two measurements (Resting \& Coughing) - The lower the score the better outcome for the patient. The highest total score (worst possible score) for the 10 timepoints would be 2000.
Time frame: 1, 1.5, 2, 3, 4, 5, 6, 24, 48 and 72 hours after Time 0
Patient's Global Evaluation of the Study Treatment on a 5 Point Likert Scale
For the 5-point categorical scale global evaluation of study treatment, the patient was instructed to score his global evaluation of the pain control provided by the study treatment where: 0 = poor, 1 = fair, 2 = good, 3 = very good and 4 = excellent
Time frame: At 72 hours after time 0
VAS Pain Intensity Scores Over Time
For the VAS assessment, patients measured their pain intensity at rest and after aggravated movement (cough) using a horizontal 100-mm VAS scale labeled as follows: No Pain (0 mm) as the left anchor and Worst Pain Imaginable (100 mm) as the right anchor.
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Time frame: At 1, 1.5, 2,3,4,5,6,24,48,72 Hours
Categorical Pain Intensity Scores Over Time - AT REST
For the 4-point categorical scale assessment, patients measured their pain intensity at rest and after aggravated movement (cough) using a numerical scale where: 0 = "none," 1 = "mild," 2 = "moderate" and 3 = "severe."
Time frame: At 0.5, 1, 1.5, 2, 3, 4, 5, 6, 24, 48 and 72 hours
Categorical Pain Relief Scores Over Time - AT REST
For the 5-point categorical scale assessment of pain relief, the patient was instructed to score his pain relief using a numerical scale where: 0 = no relief, 1 = a little relief, 2 = some relief, 3 = a lot of relief and 4 = complete relief.
Time frame: At 0.5, 1, 1.5, 2, 3, 4, 5, 6, 24, 48 and 72 hours
Categorical Pain Intensity Scores Over Time (After Cough)
For the 4-point categorical scale assessment, patients measured their pain intensity at rest and after aggravated movement (cough) using a numerical scale where: 0 = "none," 1 = "mild," 2 = "moderate" and 3 = "severe." Higher Score means a worse outcome
Time frame: At 0.5, 1, 1.5, 2, 3, 4, 5, 6, 24, 48 and 72 hours
Categorical Pain Relief Scores Over Time (After Cough)
For the 5-point categorical scale assessment of pain relief, the patient was instructed to score his pain relief using a numerical scale where: 0 = no relief, 1 = a little relief, 2 = some relief, 3 = a lot of relief and 4 = complete relief.
Time frame: At 0.5, 1, 1.5, 2, 3, 4, 5, 6, 24, 48 and 72 hours