Osteoarthritis Clinical Trial
Official title:
Liposomal Bupivacaine vs. Interscalene Nerve Block for Pain Control After Total Shoulder Arthroplasty: A Randomized Clinical Trial
This study will compare interscalene nerve block versus liposomal bupivacaine (Exparel) for pain control after total shoulder replacements. Each method will be assessed in terms of post operative pain scores, pain medication consumption, length of stay, complications (nerve injuries, hematomas, cardiac/respiratory events) and rate of readmission due to pain. The aims of this study will be achieved through a randomized controlled trial and cost-effectiveness analysis.
After the decision to proceed with shoulder replacement surgery, patients will be asked to
participate in this randomized trial. Consent will be completed after explanation of each
treatment group and the data to be collected. Patients will be randomized into one of the two
treatment groups by simple randomization into one of two groups: Group 1 will receive
interscalene nerve block and group 2 will receive liposomal bupivacaine for postoperative
analgesia. Randomization will be stratified by site.
The surgeon at each site will be trained prior to enrollment on the correct way to perform
Exparel injections intraoperatively. Patients in the interscalene nerve block group will be
given a single shot block in the preoperative area by a fellowship-trained anesthesiologist.
The primary outcome is pain score on a visual analog scale (VAS) at 24 hours postoperatively.
VAS pain scores range from 0 (no pain) to 10 (unbearable pain). Secondary outcomes are
postoperative VAS pain scores at 6, 12, 18, 30, 36, 42, 48, 54, 60, 66, 72, 78, 84, 90, and
96 hours; VAS pain score at the first postoperative visit ; intraoperative opioid
consumption; postoperative opioid consumption at days 1, 2, 3, and 4; total opioid
consumption at day 1 (intraoperative + postoperative day 1); duration of stay in the
post-anesthesia care unit (PACU); duration of hospital stay; and VAS score for satisfaction
with pain control in the hospital and at home, assessed at participants' first postoperative
visit. VAS satisfaction scores range from 0 (not satisfied) to 10 (completely satisfied).
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