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Adult Patients Undergoing Open Colectomy MA402S23B303 (IMPROVE-Open)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01507246
Recruitment Status : Completed
First Posted : January 10, 2012
Results First Posted : May 8, 2013
Last Update Posted : May 8, 2013
Information provided by (Responsible Party):
Pacira Pharmaceuticals, Inc

Brief Summary:
This study is designed to compare the standard of care against EXPAREL(R) to determine if total opioid consumption is reduced when using EXPAREL, therefore possibly reducing total hospitalization costs.

Condition or disease Intervention/treatment Phase
Bowel Obstruction Drug: IV morphine sulfate Drug: EXPAREL (bupivacaine liposome injectable suspension) Phase 4

Detailed Description:
This is a phase 4, prospective, sequential, open-label study designed to evaluate the efficacy, safety, and health economic benefits of intraoperative local wound infiltration with EXPAREL compared with postsurgical administration of standardized intravenous (IV) morphine sulfate or sponsor-approved equivalent for postsurgical analgesia in adult patients undergoing open colectomy with general anesthesia.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 42 participants
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: A Pain Relief Trial Utilizing the Infiltration of a Multivesicular Liposome Formulation Of Bupivacaine, EXPAREL®: A Phase 4 Health Economic Trial in Adult Patients Undergoing Open Colectomy
Study Start Date : December 2011
Actual Primary Completion Date : July 2012
Actual Study Completion Date : August 2012

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: IV morphine sulfate
Standard of Care (SOC), dosage variable, administered intravenously via PCA pump postsurgically, as need.
Drug: IV morphine sulfate
Patients in this group will receive IV morphine sulfate via PCA pump, as needed. The PCA pump will be set up postsurgically as soon as possible and prior to the patient leaving the PACU or immediately upon transfer to the floor if the stay in the PACU is less than one hour.
Other Name: morphine sulfate (or Sponsor-approved equivalent)

Experimental: EXPAREL (bupivacaine liposome injectable suspension)
EXPAREL(R), dosage 266 mg, diluted with 0.9% saline to a total volume of 40 cc.
Drug: EXPAREL (bupivacaine liposome injectable suspension)

Patients in this group will receive 266 mg EXPAREL diluted with preservative free 0.9% normal saline to a total volume of 30 cc and administered via wound infiltration prior to wound closure. When not contraindicated, 30 mg IV ketorolac will be given at the end of surgery. If not indicated, an IV non-steroidal anti-inflammatory drug (NSAID) may be substituted per the site's standard of care.

All patients will be offered rescue analgesia, as needed.

Other Name: bupivacaine free base

Primary Outcome Measures :
  1. Total Opioid Burden [ Time Frame: Wound closure to time hospital discharge order written or Day 30, whichever is sooner ]
    Total opioid consumed (IV and PO) postsurgically until the hospital discharge order is written or through Day 30, whichever is sooner.

  2. Health Economic Benefits - Total Cost of Hospitalization [ Time Frame: Wound closure to time hospital discharge order written or Day 30, whichever is sooner. ]
    Total cost of hospitalization until the time hospital discharge order is written or through Day 30, whichever is sooner.

  3. Health Economic Benefits - Length of Stay [ Time Frame: Up to Day 30 ]
    Length of stay (LOS), recorded in hours and converted to days with one decimal of precision, defined as the time of completion of the wound closure until the hospital discharge order is written or through Day 30, whichever is sooner.

Secondary Outcome Measures :
  1. Incidence of Predefined Opioid-related Adverse Events [ Time Frame: From the time the informed consent is signed to the time hospital discharge order is written or through Day 30 (after surgery), which ever is sooner ]
    The incidence of predefined opioid-related adverse events

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male or female, 18 years of age and older.
  • Patients scheduled to undergo open segmental colectomy with planned primary anastamosis, as defined by cecectomy, right hemicolectomy, resection of transverse colon, left hemicolectomy, or sigmoidectomy.
  • Ability to provide informed consent, adhere to study visit schedule, and complete all assessments.

Exclusion Criteria:

  • Patients with a history of hypersensitivity or idiosyncratic reactions or intolerance to any local anesthetic, opioid, or propofol.
  • Patients who abuse alcohol or other drug substance.
  • Patients with severe hepatic impairment.
  • Patients currently pregnant or who may become pregnant during the course of the study.
  • Patients with any psychiatric, psychological, or other condition that the Investigator feels may make the patient an inappropriate candidate for this clinical study.
  • Patients who have participated in an EXPAREL study within the last 30 days.
  • Patients who have received an investigational drug within 30 days prior to study drug administration, or planned administration of another investigational product or procedure during the patient's participation in this study.
  • Patients who undergo any concurrent surgical procedure during the ileostomy reversal surgery

In addition, the patient will be ineligible if he/she meets the following criteria during surgery:

  • Patients who have any concurrent surgical procedure.
  • Patients with unplanned multiple segmental resections or large intestine.
  • Patients who have unplanned, temporary or permanent colostomies, ileostomies, or the like placed.
  • Patients who receive intraoperative administration of opioids (other than fentanyl or analogs) or an other analgesic, local anesthetics, or anti-inflammatory agents.
  • Patients who receive Entereg(R).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01507246

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United States, Georgia
Atlanta Colon and Rectal Surgery
Riverdale, Georgia, United States, 30274
Sponsors and Collaborators
Pacira Pharmaceuticals, Inc
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Principal Investigator: Stephen Cohen, M.D. Atlanta Colon and Rectal Surgery
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Pacira Pharmaceuticals, Inc Identifier: NCT01507246    
Other Study ID Numbers: MA402S23B303
First Posted: January 10, 2012    Key Record Dates
Results First Posted: May 8, 2013
Last Update Posted: May 8, 2013
Last Verified: May 2013
Keywords provided by Pacira Pharmaceuticals, Inc:
open colectomy
Additional relevant MeSH terms:
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Intestinal Obstruction
Intestinal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Anesthetics, Local
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents
Analgesics, Opioid