Intraperitoneal Bupivacaine for Pelvic Organ Prolapse

NCT06120530 | Completed Phase 4 Results DMC FDA Drug

• 1 other identifier: 17120
• Study Type: interventional
• Target: 91
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate the effects of 30 mL intraperitoneal Bupivacaine without epinephrine 0.25% on postoperative pain control in patients undergoing pelvic organ prolapse repair. The investigators hypothesize that use of intraperitoneal Bupivacaine will decrease postoperative pain scores and opiate consumption in the postoperative period, following pelvic organ prolapse repair.

Conditions

Pelvic Organ Prolapse

Outcome Measures

Primary Outcomes (1)

• Pain Score at 4 Hours

  Patient pain will be measured by means of a numeric rating scale (scale from 0-10 with lower numbers indicating less pain and higher numbers indicating more pain) at 4 hours after surgical pelvic organ prolapse repair

  4 hours

Secondary Outcomes (4)

• Pain Score at 8 Hours, 12 Hours and 24 Hours

  8 hours, 12 hours and 24 hours

• Total Opiate Consumption

  First 24 hours postoperatively

• Time to First Narcotic

  Up to 24 hours

• Hospital Length of Stay

  Up to 24 hours

Study Arms (2)

Intraperitoneal bupivacaine

ACTIVE COMPARATOR

30 mL of bupivacaine without epinephrine 0.25%

Drug: Bupivacaine

placebo

PLACEBO COMPARATOR

Saline

Other: Saline

Interventions

Bupivacaine DRUG

Intraperitoneal Bupivicaine without epinephrine 30 mg administered following completion of pelvic organ prolapse repair.

Intraperitoneal bupivacaine

Saline OTHER

Placebo

placebo

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• List the criteria:
• Age \>= 18 years
• Access to cell phone with text messaging capabilities (for same day surgery discharge)

You may not qualify if:

• List the criteria:
• Bupivacaine allergy
• History of epilepsy or other seizure disorder
• EKG demonstrating asymptomatic sinus bradycardia \<40 bpm, symptomatic sinus bradycardia \<60 bpm, first degree AV block, second degree AV block, third degree AV block, prolonged QT, atrial fibrillation, supraventricular tachycardia, or myocardial infarction
• Chronic liver disease proved by any ALT or AST elevation greater than 2x upper limit of normal
• Serum bilirubin elevation in excess of 5 mg/dL
• G6PD deficiency
• Weight less than 100 lbs
• Chronic opiate use

Sponsors & Collaborators

• Indiana University: lead

Study Sites (1)

IU north

Carmel, Indiana, 46032, United States

Location

Related Publications (23)

• Melnyk M, Casey RG, Black P, Koupparis AJ. Enhanced recovery after surgery (ERAS) protocols: Time to change practice? Can Urol Assoc J. 2011 Oct;5(5):342-8. doi: 10.5489/cuaj.11002.

  PMID: 22031616 BACKGROUND

• Meyer LA, Lasala J, Iniesta MD, Nick AM, Munsell MF, Shi Q, Wang XS, Cain KE, Lu KH, Ramirez PT. Effect of an Enhanced Recovery After Surgery Program on Opioid Use and Patient-Reported Outcomes. Obstet Gynecol. 2018 Aug;132(2):281-290. doi: 10.1097/AOG.0000000000002735.

  PMID: 29995737 BACKGROUND

• Pan C, Hale D, Heit M. Enhanced Recovery Protocol Enhances Postdischarge Recovery After Laparoscopic Sacrocolpopexy. Female Pelvic Med Reconstr Surg. 2021 Nov 1;27(11):667-671. doi: 10.1097/SPV.0000000000001042.

  PMID: 34171879 BACKGROUND

• Mehr AA, Elmer-Lyon C, Maetzold E, Bradley CS, Kowalski JT. Effect of Enhanced Recovery Protocol on Opioid Use in Pelvic Organ Prolapse Surgery. Female Pelvic Med Reconstr Surg. 2021 Dec 1;27(12):e705-e709. doi: 10.1097/SPV.0000000000001114.

  PMID: 34807884 BACKGROUND

• Hota LS, Warda HA, Haviland MJ, Searle FM, Hacker MR. Opioid use following gynecologic and pelvic reconstructive surgery. Int Urogynecol J. 2018 Oct;29(10):1441-1445. doi: 10.1007/s00192-017-3474-5. Epub 2017 Sep 9.

  PMID: 28889218 BACKGROUND

• Reagan KML, Boyles SH, Brueseke TJ, Linder BJ, Willis-Gray MG, Cichowski SB, Long JB. Postoperative Opioid Prescribing After Female Pelvic Medicine and Reconstructive Surgery. Female Pelvic Med Reconstr Surg. 2021 Nov 1;27(11):643-653. doi: 10.1097/SPV.0000000000001113.

  PMID: 34669653 BACKGROUND

• Struller F, Weinreich FJ, Horvath P, Kokkalis MK, Beckert S, Konigsrainer A, Reymond MA. Peritoneal innervation: embryology and functional anatomy. Pleura Peritoneum. 2017 Dec 1;2(4):153-161. doi: 10.1515/pp-2017-0024.

  PMID: 30911646 BACKGROUND

• SHEAR L, SWARTZ C, SHINABERGER JA, BARRY KG. KINETICS OF PERITONEAL FLUID ABSORPTION IN ADULT MAN. N Engl J Med. 1965 Jan 21;272:123-7. doi: 10.1056/NEJM196501212720303. No abstract available.

  PMID: 14224216 BACKGROUND

• Moiniche S, Jorgensen H, Wetterslev J, Dahl JB. Local anesthetic infiltration for postoperative pain relief after laparoscopy: a qualitative and quantitative systematic review of intraperitoneal, port-site infiltration and mesosalpinx block. Anesth Analg. 2000 Apr;90(4):899-912. doi: 10.1097/00000539-200004000-00024.

  PMID: 10735797 BACKGROUND

• Lowenstein L, Zimmer EZ, Deutsch M, Paz Y, Yaniv D, Jakobi P. Preoperative analgesia with local lidocaine infiltration for abdominal hysterectomy pain management. Eur J Obstet Gynecol Reprod Biol. 2008 Feb;136(2):239-42. doi: 10.1016/j.ejogrb.2006.11.008. Epub 2006 Dec 18.

  PMID: 17178187 BACKGROUND

• Zacharakis D, Prodromidou A, Douligeris A, Athanasiou S, Hadzilia S, Kathopoulis N, Athanasiou V, Grigoriadis T. Preemptive Infiltration of Local Anesthetics During Vaginal Hysterectomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Urogynecology (Phila). 2022 Oct 1;28(10):667-678. doi: 10.1097/SPV.0000000000001221. Epub 2022 Jun 27.

  PMID: 35759786 BACKGROUND

• Zahiri Sorouri Z, Milani F, Heidarzadeh A, Akhavan Azari M. Intraperitoneal Instillation of Lidocaine for Postoperative Pain Relief after Total Abdominal Hysterectomy: A Double Blinded Randomized Placebo-controlled Trial. Iran J Pharm Res. 2020 Spring;19(2):317-322. doi: 10.22037/ijpr.2020.1101084.

  PMID: 33224238 BACKGROUND

• Visalyaputra S, Lertakyamanee J, Pethpaisit N, Somprakit P, Parakkamodom S, Suwanapeum P. Intraperitoneal lidocaine decreases intraoperative pain during postpartum tubal ligation. Anesth Analg. 1999 May;88(5):1077-80. doi: 10.1097/00000539-199905000-00020.

  PMID: 10320172 BACKGROUND

• Safari S, Rokhtabnak F, Djalali Motlagh S, Ghanbari Garkani M, Pournajafian A. Effect of intraperitoneal bupivacaine on postoperative pain in laparoscopic bariatric surgeries. Surg Obes Relat Dis. 2020 Feb;16(2):299-305. doi: 10.1016/j.soard.2019.10.028. Epub 2019 Nov 7.

  PMID: 31836291 BACKGROUND

• Elhakim M, Elkott M, Ali NM, Tahoun HM. Intraperitoneal lidocaine for postoperative pain after laparoscopy. Acta Anaesthesiol Scand. 2000 Mar;44(3):280-4. doi: 10.1034/j.1399-6576.2000.440310.x.

  PMID: 10714840 BACKGROUND

• Williams DJ, Walker JD. A nomogram for calculating the maximum dose of local anaesthetic. Anaesthesia. 2014 Aug;69(8):847-53. doi: 10.1111/anae.12679. Epub 2014 May 12.

  PMID: 24820093 BACKGROUND

• Kahokehr A, Sammour T, Vather R, Taylor M, Stapelberg F, Hill AG. Systemic levels of local anaesthetic after intra-peritoneal application--a systematic review. Anaesth Intensive Care. 2010 Jul;38(4):623-38. doi: 10.1177/0310057X1003800404.

  PMID: 20715724 BACKGROUND

• Bahrami, Z H, et al. "Evaluation of Lidocaine and Bupivacaine in Post Operation Pain after Abdominal Hysterectomy." Journal of Mazandaran University of Medical Sciences, vol. 16, no. 53, Aug. 2006, pp. 1-8., http://jmums.mazums.ac.ir/article-1-899-en.html.

  BACKGROUND

• Shalan, Hesham, et al. "Effect of Intraperitoneal Bupivacaine on Postoperative Pain Following Laparoscopic Pelvic Surgery." Gynaecological Endoscopy, vol. 11, no. 6, 2002, pp. 371-375., https://doi.org/10.1111/j.1365-2508.2002.00557.x.

  BACKGROUND

• Datta, Pramatha Nath, and Arijit Roy. "Role of Intraperitoneal Instillation of Bupivacaine after Laparoscopic Cholecystectomy for Post-Operative Pain Management: A Randomized Controlled Trial." International Surgery Journal, vol. 7, no. 10, 2020, p. 3239., https://doi.org/10.18203/2349-2902.isj20203986.

  BACKGROUND

• Al Kizwini, Ghassan. "Intra-Peritoneal Xylocaine Spraying for Postoperative Pain Control in Laparoscopic Cholecystectomy: A Prospective Study at Al-Yarmouk Teaching Hospital." Mustansiriya Medical Journal, vol. 16, no. 3, Dec. 2017, pp. 83-90., https://www.iasj.net/iasj/download/85fb88f576d0dfbc.

  BACKGROUND

• Alemrajabi, Mahdi, et al. "Intraperitoneal Lavage with Bupivacaine 0.2% and Post-Operative Pain in Laparoscopic Colorectal Surgery: A Prospective, Double-Blind, Randomized Controlled Trial." Journal of Kerman University of Medical Sciences, vol. 27, no. 6, 29 Sept. 2020, pp. 510-519., https://doi.org/10.22062/JKMU.2020.91526.

  BACKGROUND

• Darwish, Atef M., and Zein E. Zareh Hassan. "Intraperitoneal Bupivacaine vs. Tramadol for Pain Relief Following Day Case Laparoscopic Surgery." Gynaecological Endoscopy, vol. 8, no. 3, 1999, pp. 169-173., https://doi.org/10.1046/j.1365-2508.1999.00249.x.

  BACKGROUND

MeSH Terms

Conditions

Pelvic Organ Prolapse

Interventions

Bupivacaine; Sodium Chloride

Condition Hierarchy (Ancestors)

Prolapse; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines; Chlorides; Hydrochloric Acid; Chlorine Compounds; Inorganic Chemicals; Sodium Compounds

Limitations and Caveats

Limitations of this study include the lack of preoperative baseline pain assessment. Additionally, because pain assessments were obtained based on surgery end time, there is likely some variability in the time interval between intervention administration and pain assessment. Lastly, time to first narcotic dose could only be assessed among those that required opioids inpatient, thus resulting in lower power.

Results Point of Contact

• Title: Jose Lazaro
• Organization: Indiana University School of Medicine

jlazarow@iu.edu

7274241947

Study Officials

• James R Stewart

  Indiana University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Clinical Obstetrics & Gynecology

Study Record Dates

• First Submitted: July 29, 2023
• First Posted: November 7, 2023
• Study Start: August 16, 2023
• Primary Completion: March 15, 2024
• Study Completion: March 15, 2024
• Last Updated: April 20, 2025
• Results First Posted: April 20, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)