A multicenter, single-dose study in children 12 to \<17 years of age, 6 to \<12 years of age, and 2 to \<6 years of age who are scheduled for elective open inguinal hernia repair. Enrollment in this study will start with the oldest age group (12 to \<17 years) and will continue in a stepwise fashion until appropriate doses are established for all 3 pediatric age groups (12 to \<17 years, 6 to \<12 years, 2 to \<6 years).
This is a multicenter, single-dose study in children 12 to \<17 years of age, 6 to \<12 years of age, and 2 to \<6 years of age who are scheduled for elective open inguinal hernia repair. Within 21 days of surgery, eligible subjects will be screened and have routine clinical laboratory testing and an electrocardiogram performed. Subjects will then undergo an open inguinal hernia repair under general anesthesia according to the investigator's standard surgical practice on day 1. Enrollment in this study will start with the oldest age group (12 to \<17 years) and will continue in a stepwise fashion until appropriate doses are established for all 3 pediatric age groups. Within each age group, the study will be conducted in 3 parts. Children in each age group who are randomized to INL-001 will receive approximately less than or equal to 2.5 mg/kg of INL-001. Study drug will be administered prior to wound closure. The INL-001 implant will be cut before placement into the surgical site using sterile technique. Children randomized to 0.25% bupivacaine HCl injection will receive 2.5 mg/kg according to standard practice. After completion of the surgical procedure, all subjects will remain in the post-anesthesia care unit for at least 3 hours and will be continuously monitored for safety. At the discretion of the investigator, subjects may receive rescue medication (opioid or nonopioid) upon request for the management of breakthrough pain and may receive an antiemetic for the management of nausea or vomiting. After the initial 3-hour period, subjects who are deemed stable may be discharged to the hospital ward. Subjects will remain housed in the hospital ward for at least 48 hours. Blood samples will be collected for pharmacokinetic analysis from a subset of 8 children in each age group after INL-001 is implanted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
159
Placement of the bupivacaine collagen-matrix in the surgical site
Infiltration of the surgical site
Alliance Research Centers
Laguna Hills, California, United States
RECRUITINGCornerstone Research Institute
Altamonte Springs, Florida, United States
RECRUITINGAdverse events
Possibly related to bupivacaine toxicity
Time frame: 30 days
Blood pressure (systolic/diastolic)
Signs/symptoms of bupivacaine toxicity
Time frame: Starting at Time 0 and continuing for 3 hours and then 5, 8, 12, 24, 36, and 48 hours after Time 0
Heart rate
Signs/symptoms of bupivacaine toxicity
Time frame: Continuously from Time 0 through 3 hours, and then 5, 8, 12, 24, 36, and 48 hours after Time 0
Respiratory rate
Signs/symptoms of bupivacaine toxicity
Time frame: Continuously from Time 0 through 3 hours, and then 5, 8, 12, 24, 36, and 48 hours after Time 0
Body temperature
Signs/symptoms of bupivacaine toxicity
Time frame: Through Day 30
12-lead ECG
Screening only
Time frame: 1 day at screening
3-lead ECG
Signs/symptoms of bupivacaine toxicity
Time frame: Starting at Time 0 and continuing for at least 3 hours
Oxygen saturation levels
Pulse oximetry
Time frame: Starting at Time 0 and continuing for at least 3 hours
Clinical laboratory testing
Collection of blood and urine samples
Time frame: 1 day at screening
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Medical Research Center
Miami, Florida, United States
WITHDRAWNElion & Volhard Pharmaceutical Research (E&V PR)
Miami, Florida, United States
WITHDRAWNChildren's Hospital of Pittsburgh of UPMC (CHP-UPMC)
Pittsburgh, Pennsylvania, United States
RECRUITINGDriscoll Children's Hospital
Corpus Christi, Texas, United States
RECRUITINGEl Paso Children's Hospital
El Paso, Texas, United States
RECRUITINGMemorial Hermann Memorial City Medical Center
Houston, Texas, United States
RECRUITINGThe Woman's Hospital of Texas
Houston, Texas, United States
WITHDRAWNPlano Surgical Hospital
Plano, Texas, United States
RECRUITING...and 1 more locations
Wound healing assessments
Inspection of surgical wound site for signs of wound infection and dehiscence.
Time frame: Assessment on Day 1 through Day 3; follow-up evaluations on Days 7, 15 and 30
Nausea
Measured using a categorical scoring system (none = 0, mild = 1, moderate = 2, and severe = 3). Nausea scores will also be recorded immediately before the use of rescue antiemetics
Time frame: 1, 2, 4, 6, 12, 24, 36, and 48 hours after Time 0
Sedation
Sedation scores: awake and alert = 0, quietly awake = 1, asleep but easily roused = 2, and deep sleep = 3.
Time frame: 1, 2, 4, 6, 12, 24, 36, and 48 hours after Time 0
Cmax
Maximum observed plasma concentration
Time frame: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0.
AUC0-last
Area under the plasma concentration time curve from Time zero to last quantifiable plasma concentration
Time frame: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
AUC0-∞
Area under the plasma concentration time curve from Time zero to extrapolated through infinity
Time frame: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
Tmax
Time to maximum obserbved plasma concentration
Time frame: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
t1/2
Apparent first-order terminal elimination half-life
Time frame: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
Pain intensity
Assessed using an 11-point NRS (for children 12 to \<17 years of age), a FACES pain severity scale (children 4 through \<12 years of age), or FLACC (children 2 and 3 years of age) immediately before the child receives any parenteral or oral rescue medication for breakthrough pain
Time frame: 1, 2, 4, 6, 12, 24, 36, and 48 hours after Time 0