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Phase 4 N=150 Prevention

ESP Block for Post Cesarean Analgesia

Cesarean Section Complications

Enrolled (actual)
150
Serious AEs
0.0%
Results posted
Feb 2025
Primary outcome: Primary: Postoperative Oxycodone Consumption 0- 48 Hours After Cesarean Delivery — 12.5; 25 mg

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Erector Spinae Plane (ESP) Block (Procedure); bupivacaine liposome injectable suspension (Drug); bupivacaine (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
Female
Sponsor
Duke University
Primary completion
Nov 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Postoperative Oxycodone Consumption 0- 48 Hours After Cesarean Delivery
12.5; 25
SECONDARY
Postoperative Opioid Consumption at 24 Hours
7.5; 15
SECONDARY
Time to First Postsurgical Opioid Rescue Medication
12.2; 3.2
SECONDARY
Area Under the Curve (AUC) of Verbal Rating Scale (VRS) Pain Intensity Scores
115; 140
SECONDARY
Number of Participants With Postoperative Nausea and Vomiting
12
SECONDARY
Number of Participants With the Need for Rescue Antiemetics
8; 48
SECONDARY
Number of Participants With Pruritus
21
SECONDARY
Number of Participants With the Need for Rescue Antipruritics
5; 30
SECONDARY
Number of Participants Not Receiving Any Rescue Opioids Postoperatively
6; 27

Summary

The purpose of this pilot study is to assess the analgesic efficacy of Erector Spinae Plane block (ESPB) with liposomal bupivacaine in women undergoing cesarean delivery and receiving a postoperative multimodal analgesic regimen as assessed by the dose of rescue postoperative opioids compared to a historical control group of women receiving the same multimodal regimen but with no truncal blocks. This will be a case control study with a prospective and a retrospective component. Women undergoing elective cesarean delivery under spinal or combined spinal epidural anesthesia will be approached to participate in the prospective open label component of the study. Cases will be matched in a 1:4 ratio by age, race, history of prior cesarean delivery, and insurance status with historical controls who received the same multimodal analgesic regimen but no truncal blocks. We plan to enroll 30 subjects for the prospective arm of the study and 120 for the retrospective arm.

Eligibility Criteria

Inclusion Criteria

  • Patients ≥18 years of age with a term pregnancy of 37 to 42 weeks and American Society of Anesthesiologists Physical Status Classification II or III scheduled to undergo elective CD.

Exclusion Criteria

  • ≥3 prior CDs, pre-pregnancy body mass index >40 kg/m2, planned concurrent surgical procedure other than tubal ligation, chronic pain or chronic opioid therapy, any clinically significant event or condition uncovered during surgery (eg, excessive bleeding, acute sepsis) that might render the patient medically unstable or complicate the patient's postsurgical course, or allergy or contraindication to any component of the multimodal analgesic regimen.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05664958). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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