This is a national, single-center, single-arm, open-label Phase II clinical trial designed to evaluate the efficacy and safety of Ropiclobet, a fixed-dose injectable solution containing Ropivacaine HCl, Betamethasone Sodium Phosphate, and Clonidine HCl. The study includes three non-randomized dose groups and will enroll a total of 60 adult volunteers undergoing upper extremity surgery (arm, elbow, forearm, or hand). All participants will receive a single administration of Ropiclobet via supraclavicular brachial plexus block (SCB) under ultrasound guidance. Sedation may be provided if necessary; however, participants requiring general anesthesia will be excluded from the study. Postoperatively, volunteers will be monitored in the PACU for 2 hours, followed by transfer to a regular hospital ward under anesthesiology supervision. All participants will remain under clinical observation for 48 hours following the procedure. If the sensory or motor block persists beyond this period, monitoring will continue until full resolution and an additional 6 hours of observation will be provided. Follow-up visits are scheduled for Day 15 and Day 30 post-procedure. The primary efficacy endpoint is the duration of analgesia and the primary safety endpoint is the incidence and characterization of all adverse events occurring during the procedure and within 30 days postoperatively.
This national, single-center, single-arm, open-label Phase II clinical trial includes three dose groups and aims to evaluate the efficacy and safety of Ropiclobet. Ropiclobet Injectable Solution is a fixed-dose combination containing Ropivacaine HCl, Betamethasone Sodium Phosphate, and Clonidine HCl at concentrations of 5.0/0.4\*/0.015 mg/mL (\*the 10 mL ampoule contains 0.53 mg of betamethasone sodium phosphate, equivalent to 0.4 mg of betamethasone). A total of 60 volunteers (Hospitalized patients in the orthopedic department or outpatients who are scheduled for surgery) undergoing upper extremity surgery (including arm, elbow, forearm, and hand surgeries) will receive a single administration of the Ropiclobet combination via supraclavicular brachial nerve blockade (SCB) under ultrasound guidance. The study will include three dose groups: * Group I: 10 mL Ropiclobet combination (1 ampoule) diluted with 10 mL of 0.9% isotonic saline * Group II: 15 mL Ropiclobet combination (1.5 ampoules) diluted with 5 mL of 0.9% isotonic saline * Group III: 20 mL Ropiclobet combination (2 ampoules), administered undiluted. There will be no randomization for dose groups. The first 20 participants will be assigned to Group I. The study team will assess safety and efficacy parameters in these participants. Following the completion of 20 participants in Group I, the study will proceed to Group II. Group III will follow in the same manner, with 20 participants planned per group. Ropiclobet injection will be performed preoperatively under sterile conditions by an experienced anesthesiologist. Only sedation may be administered if needed, and volunteers requiring general anesthesia will be withdrawn from the study. Standard monitoring will include ECG, non-invasive blood pressure measurement, and pulse oximetry. Postoperatively, volunteers will be monitored in the PACU for 2 hours, followed by observation in the hospital ward under an anesthesiologist's supervision. Volunteers will remain under clinical observation for 48 hours post-procedure. If motor or sensory blockade persists beyond this period, monitoring will continue until full resolution plus an additional 6 hours. Follow-up visits will be at Day 15 and Day 30.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Ropivacaine HCl - Betamethasone Sodium Phosphate - Clonidine HCl 5.0/0.4\*/0.015 mg/mL (The solution contains 0.53 mg of betamethasone sodium phosphate, equivalent to 0.4 mg of betamethasone) Group I: A total of 20 mL will be injected: 10 mL Ropiclobet (1 ampoule) + 10 mL of 0.9% isotonic saline
Ropivacaine HCl - Betamethasone Sodium Phosphate - Clonidine HCl 5.0/0.4\*/0.015 mg/mL (The solution contains 0.53 mg of betamethasone sodium phosphate, equivalent to 0.4 mg of betamethasone) Group II: A total of 20 mL will be injected: 15 mL Ropiclobet (1.5 ampoules) + 5 mL of 0.9% isotonic saline
Ropivacaine HCl - Betamethasone Sodium Phosphate - Clonidine HCl 5.0/0.4\*/0.015 mg/mL (The solution contains 0.53 mg of betamethasone sodium phosphate, equivalent to 0.4 mg of betamethasone) Group III: A total of 20 mL will be injected: 20 mL Ropiclobet (2 ampoules)
Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital
Istanbul, Turkey (Türkiye)
Duration of analgesia
Time frame: From end of Ropiclobet injection to the first sensation of pain at surgical site (minutes/hours), up to 48 hours
Number of treatment-related adverse events assessed by NCI-CTCAE
Time frame: From the beginning of the nerve block procedure to the end of study visit at 30 days
Pain at rest
Assessment of pain at rest using the Visual Analog Scale (VAS), 0-10 scale (0 (no pain) to 10 (worst possible pain))
Time frame: pre-block, and 0, 2, 4, 6, 12, 18, 24 and 48 hours post-block, on Day 15 and 30.
Pain during movement
Assessment of pain during movement of the surgical site using Visual Analog Scale (VAS), 0-10 scale (0 (no pain) to 10 (worst possible pain))
Time frame: pre-block, and 0, 2, 4, 6, 12, 18, 24 and 48 hours post-block, on Day 15 and 30
Onset time of motor block
Onset time of motor block is defined as the time (hour/minutes) from the completion of Ropiclobet injection to the onset of motor block. This will be assessed by grip strength test.
Time frame: Pre-block, and at 5, 10, 15, 20, 25, 30 minutes, as well as 6, 12, 24 and 48 hours post-injection.
Duration of motor block
The time of resolution of the motor block (in minutes or hours), assessed by grip strength tests.
Time frame: From nerve block procedure to the resolution of the motor block, up to 48 hours
Onset time of sensory block
Onset time of sensory block is defined as the time (hour/minutes) from end of Ropiclobet injection to the onset of sensory block. This will be assessed by cold and touch tests across C5-C8 dermatomes.
Time frame: Pre-block, and at 5, 10, 15, 20, 25, 30 minutes, as well as 6, 12, 24 and 48 hours post-injection.
Duration of sensory block
The time of resolution of the sensorial block (in minutes or hours)
Time frame: From nerve block procedure to the resolution of the sensory block, up to 48 hours
Required rescue analgesia
Assessment of the frequency of required rescue analgesia intra-operatively.
Time frame: Perioperative (from nerve block procedure to the end of surgery)
Required rescue analgesia
Assessment of the frequency of required rescue analgesia postoperatively
Time frame: From the end of surgery up to 48 hours
Patient satisfaction
assessment of patient satisfaction using Visual Analog Scale (VAS), 0-10 scale (0=worst, 10=best)
Time frame: 24 hours following nerve block procedure, and on Day 15 and 30
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