CClinicalTrials.gg
TerminatedNCT03290196Updated Mar 30, 2025Results posted

The Effect of EXPAREL® on Postsurgical Pain, and the Use of Narcotics

A Phase 4 interventional study of EXPAREL 1.3 % in 20 ML Injection in Rotator Cuff Tear, sponsored by Andrews Research & Education Foundation. Terminated at 1 site in United States. Open to participants aged 18 Years to 72 Years. Per ClinicalTrials.gov, last updated 2025-03-30.

Sponsored by Andrews Research & Education Foundation · Phase 4, Interventional, and Treatment

Why this study was terminated
Patients pain was not regulated well with this product.
Phase
Phase 4
Study type
Interventional
Enrollment
13
Allocation
Not applicable
Ages
18 Years to 72 Years
Sex
All
01

Study summary

Patients undergoing shoulder rotator cuff surgery in an outpatient setting are the focus of this study. The purpose of this study is to determine if the product EXPAREL® can be used as a safe alternative in shoulder surgery to pain pumps, while limiting narcotic use and providing appropriate postoperative pain control.

Read the detailed description

Based on prior research, it is hypothesized EXPAREL® can potentially be used as a local anesthetic option after undergoing an arthroscopic rotator cuff repair in the outpatient setting. Conducting this study, will allow the option for a surgeon to administer a local anesthetic, in a single injection, to the exact location of the surgical procedure and in a sterile environment. The purpose of this pilot study is to determine if EXPAREL® can be used as a safe alternative to current post-operative pain control methods, while limiting narcotic use and providing appropriate postoperative analgesia.

02

Conditions studied

  • Rotator Cuff Tear

Keywords

  • Shoulder
  • Rotator cuff
03

Who can participate

Ages eligible
18 Years to 72 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Male or female
  • 18-72 years of age
  • Subjects scheduled to undergo a rotator cuff repair with a subacromial decompression by one of the protocol investigators

Exclusion criteria

Exclusion Criteria:

  • Planned concomitant glenoid labral repair
  • Previous open shoulder surgery
  • Neurological deficit or other disability involving the surgical extremity
  • Anyone with a documented allergy to bupivicaine
  • Subjects that are not mentally competent to give consent
  • Pregnant women
  • Subjects with an intolerance to hydrocodone or oxycodone and/or brand name equivalent combination medication
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
13 participants (actual)

Study arms

  • Other
    EXPAREL 1.3 % in 20 ML Injection

    EXPAREL (bupivacaine liposome injectable suspension, 20 mL single use vial, 1.3% \[13.3 mg/mL\]) is a liposome injection of bupivacaine, an amide local anesthetic, indicated for single-dose infiltration into the surgical site to produce postsurgical analgesia. EXPAREL dosage is based on the following factors: * size of surgical site * volume required to cover the area * individual patient factors that may impact the safety of an amide local anesthetic * maximum doe of 266 mg (20 mL)

    Drug: EXPAREL 1.3 % in 20 ML Injection

Interventions

  • DrugEXPAREL 1.3 % in 20 ML Injection

    EXPAREL single shot dose given as an analgesia for arthroscopic rotator cuff repair surgery.

    Also known as: bupivacaine liposome injectable suspension

05

What researchers measure

Primary outcomes

  1. VAS Pain Score

    Patient reported numeric pain rating using visual analog scale (VAS) (0 = none, 10 = severe)

    Time frame: 12 hours, 24 hours, 36 hours, 48 hours

  2. Narcotic Medication Usage

    Number of narcotic medication tablets consumed

    Time frame: 12 hours, 24 hours, 36 hours, 48 hours, 3 days, 7 days, 14 days

Secondary outcomes

  1. American Shoulder and Elbow Surgeons Shoulder Score (ASES) on Surgical Arm

    American Shoulder and Elbow Surgeons Shoulder Score (ASES) of surgical arm measured utilizing patient reported outcome surveys. (0 = no function; 100 = full function)

    Time frame: 2 weeks

  2. American Shoulder and Elbow Surgeons Shoulder Score (ASES) of Healthy Arm

    American Shoulder and Elbow Surgeons Shoulder Score (ASES) of healthy (nonsurgical) arm measured utilizing patient reported outcome surveys. (0 = no function; 100 = full function)

    Time frame: 2 weeks

06

Results

Posted Mar 30, 2025

Participant flow

Participant flow — Overall Study
MilestoneEXPAREL 1.3 % in 20 ML Injection
Started13
Completed13
Not completed0

Outcome measures

PrimaryVAS Pain Score

Patient reported numeric pain rating using visual analog scale (VAS) (0 = none, 10 = severe)

Time frame:
12 hours, 24 hours, 36 hours, 48 hours
Reported as:
Mean · units on a scale
VAS Pain Score
units on a scaleEXPAREL 1.3 % in 20 ML Injection
12 Hours2.7 ± 3.0
24 Hours3.2 ± 3.5
36 Hours2.3 ± 2.7
48 Hours2.1 ± 2.6
PrimaryNarcotic Medication Usage

Number of narcotic medication tablets consumed

Time frame:
12 hours, 24 hours, 36 hours, 48 hours, 3 days, 7 days, 14 days
Reported as:
Mean · quantity of tablets
Narcotic Medication Usage
quantity of tabletsEXPAREL 1.3 % in 20 ML Injection
12 Hours1.38 ± 1.67
24 Hours1.54 ± 2.06
36 Hours1.68 ± 2.08
48 Hours1.36 ± 1.44
Day 38.18 ± 9.75
Day 714.42 ± 16.45
Day 1418.02 ± 20.07
SecondaryAmerican Shoulder and Elbow Surgeons Shoulder Score (ASES) on Surgical Arm

American Shoulder and Elbow Surgeons Shoulder Score (ASES) of surgical arm measured utilizing patient reported outcome surveys. (0 = no function; 100 = full function)

Time frame:
2 weeks
Reported as:
Mean · score on a scale
American Shoulder and Elbow Surgeons Shoulder Score (ASES) on Surgical Arm
score on a scaleEXPAREL 1.3 % in 20 ML Injection
American Shoulder and Elbow Surgeons Shoulder Score (ASES) on Surgical Arm48.8 ± 7
SecondaryAmerican Shoulder and Elbow Surgeons Shoulder Score (ASES) of Healthy Arm

American Shoulder and Elbow Surgeons Shoulder Score (ASES) of healthy (nonsurgical) arm measured utilizing patient reported outcome surveys. (0 = no function; 100 = full function)

Time frame:
2 weeks
Reported as:
Mean · score on a scale
American Shoulder and Elbow Surgeons Shoulder Score (ASES) of Healthy Arm
score on a scaleHealthy Arm
American Shoulder and Elbow Surgeons Shoulder Score (ASES) of Healthy Arm73.6 ± 23.7

Adverse events

Collected over 10 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
EXPAREL 1.3 % in 20 ML Injection0/13 (0%)0/13 (0%)0/13 (0%)

Baseline characteristics

Age, Customized
Age, Customized(years)EXPAREL 1.3 % in 20 ML Injection
Age56.6 ± 6.4
Sex: Female, Male
Sex: Female, Male(Participants)EXPAREL 1.3 % in 20 ML Injection
Female1
Male12
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)EXPAREL 1.3 % in 20 ML Injection
Region of Enrollment
Region of Enrollment(participants)EXPAREL 1.3 % in 20 ML Injection
United States13
07

Study locations

1 site
  • Andrews Research & Education Foundation
    Gulf Breeze, Florida 32561, United States
08

References and documents

Publications

  • Johnson MD, Mickler T, Arthur GR, Rosenburg S, Wilson R. Bupivacaine with and without epinephrine for intercostal nerve block. J Cardiothorac Anesth. 1990 Apr;4(2):200-3. doi: 10.1016/0888-6296(90)90238-b. PubMed 2131867 ↗
  • Colombo G, Padera R, Langer R, Kohane DS. Prolonged duration local anesthesia with lipid-protein-sugar particles containing bupivacaine and dexamethasone. J Biomed Mater Res A. 2005 Nov 1;75(2):458-64. doi: 10.1002/jbm.a.30443. PubMed 16088895 ↗
  • Bergese SD, Onel E, Morren M, Morganroth J. Bupivacaine extended-release liposome injection exhibits a favorable cardiac safety profile. Reg Anesth Pain Med. 2012 Mar-Apr;37(2):145-51. doi: 10.1097/AAP.0b013e31823d0a80. PubMed 22266897 ↗
  • Portillo J, Kamar N, Melibary S, Quevedo E, Bergese S. Safety of liposome extended-release bupivacaine for postoperative pain control. Front Pharmacol. 2014 Apr 30;5:90. doi: 10.3389/fphar.2014.00090. eCollection 2014. PubMed 24817851 ↗
  • Candiotti K. Liposomal bupivacaine: an innovative nonopioid local analgesic for the management of postsurgical pain. Pharmacotherapy. 2012 Sep;32(9 Suppl):19S-26S. doi: 10.1002/j.1875-9114.2012.01183.x. PubMed 22956491 ↗
  • Cohen SM, Vogel JD, Marcet JE, Candiotti KA. Liposome bupivacaine for improvement in economic outcomes and opioid burden in GI surgery: IMPROVE Study pooled analysis. J Pain Res. 2014 Jun 24;7:359-66. doi: 10.2147/JPR.S63764. eCollection 2014. PubMed 25018650 ↗
  • Bagsby DT, Ireland PH, Meneghini RM. Liposomal bupivacaine versus traditional periarticular injection for pain control after total knee arthroplasty. J Arthroplasty. 2014 Aug;29(8):1687-90. doi: 10.1016/j.arth.2014.03.034. Epub 2014 Apr 4. PubMed 24793570 ↗
  • Singelyn FJ, Lhotel L, Fabre B. Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg. 2004 Aug;99(2):589-92, table of contents. doi: 10.1213/01.ANE.0000125112.83117.49. PubMed 15271745 ↗
  • Borgeat A, Ekatodramis G, Kalberer F, Benz C. Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study. Anesthesiology. 2001 Oct;95(4):875-80. doi: 10.1097/00000542-200110000-00015. PubMed 11605927 ↗
  • Fredrickson MJ, Kilfoyle DH. Neurological complication analysis of 1000 ultrasound guided peripheral nerve blocks for elective orthopaedic surgery: a prospective study. Anaesthesia. 2009 Aug;64(8):836-44. doi: 10.1111/j.1365-2044.2009.05938.x. PubMed 19604186 ↗
  • Jeng CL, Torrillo TM, Rosenblatt MA. Complications of peripheral nerve blocks. Br J Anaesth. 2010 Dec;105 Suppl 1:i97-107. doi: 10.1093/bja/aeq273. PubMed 21148659 ↗

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03290196
Lead sponsor
Andrews Research & Education Foundation
Collaborators
Pacira Pharmaceuticals, Inc
Responsible party
Sponsor
First posted
Sep 21, 2017
Start date
Sep 3, 2015
Primary completion
Dec 22, 2016
Completion
Apr 7, 2022
Results posted
Mar 30, 2025
Last update
Mar 30, 2025

Study contacts

James R Andrews, MD
principal investigator · Andrews Institute for Orthopaedics & Sports Medicine

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Apr 2024. You cannot join it, but the record below documents what was studied.

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