Evaluation of the Safety and Efficacy of EXPAREL When Administered Into the TAP in Subjects Undergoing Cesarean Section

Pain Clinical Trial

Official title:

A Multicenter, Open-Label Study to Evaluate the Safety and Efficacy of EXPAREL When Administered Via Infiltration Into the Transversus Abdominis Plane (TAP) After Bupivacaine Spinal Anesthesia in Subjects Undergoing Elective Cesarean Section

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT02353754
• Other study ID #: 402-C-402
• Status: Terminated
• Phase: Phase 4
• Start date: May 2015
• Est. completion date: July 2015

Study information

• Verified date: March 2021
• Source: Pacira Pharmaceuticals, Inc
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a Phase 4, multicenter, open-label study evaluating EXPAREL infiltration into the transversus abdominis plane (TAP) after bupivacaine hydrochloride (HCl) spinal anesthesia in subjects undergoing elective Cesarean section (C-section).

Description:

There will be two groups of subjects with approximately 40 subjects per group. Prior to the C-section, all subjects will receive single-shot spinal anesthesia (1.5 mL bupivacaine HCl 0.75% with dextrose 8.25%). Subjects in Group 1 (Standard of Care) will receive intrathecal morphine injection (e.g., Duramorph®) 0.2 mg in conjunction with the single-shot spinal anesthesia. No TAP block will be administered. Subjects in Group 2 (EXPAREL/TAP) will receive a bilateral TAP infiltration with a single 20 mL dose of EXPAREL 266 mg expanded in volume with 20 mL of normal saline for a total volume of 40 mL (20 mL infiltrated on each side of the abdomen).

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 12
• Est. completion date: July 2015
• Est. primary completion date: June 2015
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Females =18 years of age at screening.

2. Scheduled to undergo elective C-section (single or multiple births).

3. American Society of Anesthesiology (ASA) physical status 1, 2, or 3.

4. Able to provide informed consent, adhere to the study visit schedule, and complete all study assessments.

Exclusion Criteria:

1. History of hypersensitivity or idiosyncratic reaction to amide-type local anesthetics or opioids.

2. Contraindication to bupivacaine, morphine, ketorolac, ibuprofen, or acetaminophen.

3. Planned concurrent surgical procedure with the exception of salpingo-oophorectomy or tubal ligation.

4. Use of any of the following medications within the times specified before surgery:

long-acting opioid medication, non-steroidal anti-inflammatory drugs (NSAIDs), or aspirin (except for low-dose aspirin used for cardioprotection) within 3 days, or any opioid medication or acetaminophen within 24 hours.

5. Initiation of treatment with any of the following medications within 1 month of study drug administration or if the medication(s) are being given to control pain: selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), gabapentin, pregabalin (Lyrica®), or duloxetine (Cymbalta®). If a subject is taking one of these medications for a reason other than pain control, she must be on a stable dose for at least 1 month prior to study drug administration.

6. Clinically significant medical or psychiatric disease that, in the opinion of the Investigator, would constitute a contraindication to participation in the study or cause inability to comply with the study requirements.

7. History of, suspected, or known addiction to or abuse of illicit drug(s), prescription medication(s), or alcohol within the past 2 years.

8. Received an investigational drug within 30 days prior to study drug administration, and/or has planned administration of another investigational product or procedure while participating in this study.

9. Previous participating in an EXPAREL study.

The subject will be withdrawn from the study if she meets the following criteria:

10. Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that might render the subject medically unstable or complicate the subject's postsurgical course.

11. Her baby's 5-minute Apgar score is =7.

Related Conditions & MeSH terms

• Pain

Intervention

Drug:
• Intrathecal morphine injection
0.2 mg
• EXPAREL
266 mg

Locations

Country	Name	City	State
United States	Montefiore	Bronx	New York
United States	The Ohio State University, Wexner Medical Center	Columbus	Ohio
United States	University Of Minnesota	Minneapolis	Minnesota
United States	Saint Peter's University Hospital	New Brunswick	New Jersey
United States	Tradition Medical Center	Port Saint Lucie	Florida

Sponsors (1)

Lead Sponsor	Collaborator
Pacira Pharmaceuticals, Inc

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Total Postsurgical Narcotic Consumption in Morphine Equivalents	Outcome measure data refer to 7 participants who received rescue medication	Through 72 hours postdose
Secondary	Total Postsurgical Narcotic Consumption in Morphine Equivalents	Outcome measure data refer to 6 participants who received rescue medication	Through 24 hours
Secondary	Total Postsurgical Narcotic Consumption in Morphine Equivalents	Outcome measure data refer to 7 participants who received rescue medication	Through 48 hours