Clinical Evaluation of the ReLeaf Analgesic Infusion Catheter & Wound Drain
Primary Purpose
Low Back Pain
Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
ReLeaf catheter
Ropivacaine
Saline
Morphine
Oxycodone
Sponsored by
About this trial
This is an interventional supportive care trial for Low Back Pain
Eligibility Criteria
Inclusion Criteria:
- Skeletally mature
- Diagnosis of lumbar spine disease requiring an open, midline, instrumented posterolateral fusion with or without interbody support at one or two vertebral levels and laminectomy or laminotomy
- Physically and mentally willing to comply with the study requirements
- Signed the study informed consent
Exclusion Criteria:
- Lumbar spine disease requiring more than two levels of instrumentation
- Any previous operative lumbar procedure, except discectomy or hemi-laminotomy performed a minimum of 2 years prior to current study surgery
- Patients requiring iliac crest bone graft for the procedure
- Intra-operative durotomy
- Any duration of pre-operative morphine or morphine equivalent use exceeding 30 mg of morphine equivalents per day for longer than 3 months
- Physically or mentally compromised (i.e., being currently treated for a psychiatric disorder, senile dementia, Alzheimer's disease, presence of alcohol or substance abuse)
- Diagnosed with Severe Depression and on treatment
- Active infection at the operative level or a symptomatic infection
- Diagnosed systemic disease that would affect the subject's welfare or overall outcome of the research study (i.e. Paget's disease, renal osteodystrophy, Lupus etc)
- Is pregnant or breast feeding
- Has any active malignancy or spinal arthrodesis being performed for a tumor decompression
- Has a known allergy to local analgesics
- Pending litigation related to back pain or injury or Worker's Compensation
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Ropivacaine
Saline
Arm Description
Continuous 0.2% Ropivacaine infusion until catheter removal (typically 36 hours)
Continuous saline infusion until catheter removal (typically 36 hours)
Outcomes
Primary Outcome Measures
Pain (Mean VAS pain score at 24 hours post-procedure)
Mean VAS pain score at 24 hours post-procedure
Secondary Outcome Measures
Medication Use
Narcotic use from surgery through 3 months post-operative
Adverse Events
Occurrence of adverse events through 3 months post-operative
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02293525
Brief Title
Clinical Evaluation of the ReLeaf Analgesic Infusion Catheter & Wound Drain
Official Title
Investigational Plan for the Clinical Evaluation of the ReLeaf Analgesic Infusion Catheter & Wound Drain
Study Type
Interventional
2. Study Status
Record Verification Date
January 2016
Overall Recruitment Status
Withdrawn
Why Stopped
No subjects were enrolled and the sponsor suspended support at this time
Study Start Date
undefined (undefined)
Primary Completion Date
January 2016 (Actual)
Study Completion Date
January 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vital 5, LLC
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to evaluate the clinical performance of the ReLeaf infusion catheter & wound drain in patients following lumbar spinal fusion surgery. One half of the patients will receive continuous local analgesic fusion during the post-operative period while the other half will received continuous local saline.
Detailed Description
Posterior lumbar spinal fusion is commonly used in the management of a wide array of spinal disorders ranging from instability to degenerative disc disease. However, severe postoperative pain is a significant adverse outcome in patients who have undergone a lumbar spinal fusion procedure. This pain may delay mobilization and decrease compliance with physical, occupational, or pulmonary physiotherapy.
Pain symptoms may worsen with activity and ambulation due to reflex spasms of the paraspinal muscles elicited by pain from the wound. A local anesthetic agent administered immediately after surgery into the tissue surrounding the wound addresses the pain source for less than four hours. Therefore, it is reasonable to consider continuous local anesthetic infusion, which may limit local pain mediators for a longer duration.
Continuous local anesthetic infusion into the paraspinal musculature with the ReLeaf catheter has the potential to reduce pain, narcotic demand & usage, and accelerate the rate of recovery in lumbar spinal fusion patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Low Back Pain
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ropivacaine
Arm Type
Active Comparator
Arm Description
Continuous 0.2% Ropivacaine infusion until catheter removal (typically 36 hours)
Arm Title
Saline
Arm Type
Placebo Comparator
Arm Description
Continuous saline infusion until catheter removal (typically 36 hours)
Intervention Type
Device
Intervention Name(s)
ReLeaf catheter
Intervention Description
Continuous infusion rate 10ml/hr (5ml/side)
Intervention Type
Drug
Intervention Name(s)
Ropivacaine
Other Intervention Name(s)
Naropin
Intervention Type
Drug
Intervention Name(s)
Saline
Intervention Type
Drug
Intervention Name(s)
Morphine
Intervention Description
Patient-controlled analgesia (PCA) at 1mg every 6 minutes with a 4 hour lock out after 30mg
Intervention Type
Drug
Intervention Name(s)
Oxycodone
Other Intervention Name(s)
Oxycontin, Roxicodone, Oxecta
Intervention Description
10mg every 4-6 hours
Primary Outcome Measure Information:
Title
Pain (Mean VAS pain score at 24 hours post-procedure)
Description
Mean VAS pain score at 24 hours post-procedure
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
Medication Use
Description
Narcotic use from surgery through 3 months post-operative
Time Frame
3 months
Title
Adverse Events
Description
Occurrence of adverse events through 3 months post-operative
Time Frame
3 months
Other Pre-specified Outcome Measures:
Title
Length of Hospital Stay
Description
Time from surgery to hospital discharge, on average 2 to 3 days
Time Frame
Discharge, on average 2 to 3 days
Title
Incisional Pain
Description
Pain at the site of the incision at 3 months post-operative
Time Frame
3 months
Title
Incidence of nausea and vomiting
Description
Occurrence of nausea with or without vomiting and treatments from time of surgery through hospital discharge (which is 2-3 days on average)
Time Frame
Discharge, on average 2 to 3 days
Title
Time of Foley Catheter Removal
Description
Time foley catheter was removed following surgery but no later than hospital discharge (which is 2-3 days on average)
Time Frame
Discharge, on average 2 to 3 days
Title
Time to First Ambulate
Description
Time to walk following surgery but no later than hospital discharge (which is 2-3 days on average)
Time Frame
Discharge, on average 2 to 3 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Skeletally mature
Diagnosis of lumbar spine disease requiring an open, midline, instrumented posterolateral fusion with or without interbody support at one or two vertebral levels and laminectomy or laminotomy
Physically and mentally willing to comply with the study requirements
Signed the study informed consent
Exclusion Criteria:
Lumbar spine disease requiring more than two levels of instrumentation
Any previous operative lumbar procedure, except discectomy or hemi-laminotomy performed a minimum of 2 years prior to current study surgery
Patients requiring iliac crest bone graft for the procedure
Intra-operative durotomy
Any duration of pre-operative morphine or morphine equivalent use exceeding 30 mg of morphine equivalents per day for longer than 3 months
Physically or mentally compromised (i.e., being currently treated for a psychiatric disorder, senile dementia, Alzheimer's disease, presence of alcohol or substance abuse)
Diagnosed with Severe Depression and on treatment
Active infection at the operative level or a symptomatic infection
Diagnosed systemic disease that would affect the subject's welfare or overall outcome of the research study (i.e. Paget's disease, renal osteodystrophy, Lupus etc)
Is pregnant or breast feeding
Has any active malignancy or spinal arthrodesis being performed for a tumor decompression
Has a known allergy to local analgesics
Pending litigation related to back pain or injury or Worker's Compensation
12. IPD Sharing Statement
Citations:
PubMed Identifier
16261108
Citation
Yukawa Y, Kato F, Ito K, Terashima T, Horie Y. A prospective randomized study of preemptive analgesia for postoperative pain in the patients undergoing posterior lumbar interbody fusion: continuous subcutaneous morphine, continuous epidural morphine, and diclofenac sodium. Spine (Phila Pa 1976). 2005 Nov 1;30(21):2357-61. doi: 10.1097/01.brs.0000184377.31427.fa.
Results Reference
background
PubMed Identifier
15220788
Citation
Gottschalk A, Freitag M, Tank S, Burmeister MA, Kreil S, Kothe R, Hansen-Algenstedt N, Weisner L, Staude HJ, Standl T. Quality of postoperative pain using an intraoperatively placed epidural catheter after major lumbar spinal surgery. Anesthesiology. 2004 Jul;101(1):175-80. doi: 10.1097/00000542-200407000-00027.
Results Reference
background
PubMed Identifier
14693613
Citation
Bianconi M, Ferraro L, Ricci R, Zanoli G, Antonelli T, Giulia B, Guberti A, Massari L. The pharmacokinetics and efficacy of ropivacaine continuous wound instillation after spine fusion surgery. Anesth Analg. 2004 Jan;98(1):166-172. doi: 10.1213/01.ANE.0000093310.47375.44.
Results Reference
background
PubMed Identifier
18197109
Citation
Elder JB, Hoh DJ, Wang MY. Postoperative continuous paravertebral anesthetic infusion for pain control in lumbar spinal fusion surgery. Spine (Phila Pa 1976). 2008 Jan 15;33(2):210-8. doi: 10.1097/BRS.0b013e318160447a.
Results Reference
background
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Clinical Evaluation of the ReLeaf Analgesic Infusion Catheter & Wound Drain
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