210 Participants Needed

Local Anesthetics for Postoperative Pain in Thyroid Surgery

MX
HZ
Overseen ByHan Zhang, MD FRCSC
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: St. Joseph's Healthcare Hamilton
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests two local anesthetics, Bupivacaine and Lidocaine, to determine which better controls pain after thyroid surgery. Researchers compare the effectiveness of each drug when administered before surgery. Individuals planning thyroid surgery with a neck incision, for conditions like thyroid tumors, might be suitable candidates.

As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of participants.

Do I need to stop my current medications for this trial?

The trial does not specify if you need to stop taking your current medications. However, if you have a history of using chronic pain medications in the past 6 months, you may not be eligible to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that both Bupivacaine and Lidocaine are generally safe for managing post-surgical pain. Studies have found that Bupivacaine, particularly in its liposomal form, is well-tolerated and effectively relieves pain, with most people not experiencing serious side effects.

For Lidocaine, research indicates it effectively reduces post-surgical pain. However, using the correct dose is crucial, as excessive amounts can lead to serious side effects. When administered properly, Lidocaine is safe and effective for pain management.

Both treatments have been widely used and have a good safety record, rarely causing harmful side effects when used as directed.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments because Bupivacaine and Lidocaine, both used with epinephrine, offer unique benefits for managing postoperative pain in thyroid surgery. Unlike standard pain relief options that may rely on systemic opioids, these treatments are locally administered, which can lead to fewer side effects like nausea or drowsiness. Bupivacaine, known for its long-lasting effects, can provide extended pain relief, while Lidocaine acts quickly to numb pain. By using these local anesthetics, the goal is to enhance recovery and improve patient comfort right after surgery.

What evidence suggests that this trial's treatments could be effective for postoperative pain in thyroid surgery?

This trial will compare the effectiveness of two local anesthetics for managing postoperative pain in thyroid surgery. Research has shown that bupivacaine with epinephrine, which participants in this trial may receive, can significantly reduce pain after thyroid surgery. Patients using this combination often require less additional pain medication. Bupivacaine blocks pain signals in the nerves around the surgery area, and studies have demonstrated that it lowers pain levels, making recovery more comfortable.

Lidocaine, also mixed with epinephrine, is another treatment option in this trial for managing postoperative pain. It works quickly to numb the area and is widely used in various medical procedures. While both treatments aim to ease pain, bupivacaine often provides longer-lasting effects compared to lidocaine.23567

Who Is on the Research Team?

HZ

Han Zhang, MD FRCSC

Principal Investigator

St. Joseph's Hospital Hamilton

Are You a Good Fit for This Trial?

This trial is for individuals with certain types of thyroid disease who are planning to undergo thyroid surgery and can stay in the hospital for at least 12 hours post-surgery. It's not suitable for those with a history of diabetes, narcotic abuse, chronic pain medication use, neck radiation therapy, coagulation defects, allergies to Bupivacaine or Lidocaine, advanced thyroid cancer stages or extensive previous surgeries.

Inclusion Criteria

I am scheduled for thyroid surgery involving a cut in the middle of my neck.
I will stay in the hospital for at least 12 hours after surgery.
I have been diagnosed with thyroid disease, either a small to medium tumor or benign condition.

Exclusion Criteria

I have had kidney or liver disease in the past.
I have had radiation therapy to my neck.
I have had surgery to remove lymph nodes in my neck beyond the central area.
See 11 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Patients receive local infiltration with either Bupivacaine or Lidocaine before neck incision during thyroid surgery

1 day
1 visit (in-person)

Postoperative Monitoring

Participants are monitored for postoperative pain and analgesia utilization

72 hours

Follow-up

Participants are monitored for complications and return of sensation at the surgical site

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Bupivacaine 0.5% with 1:200 000 epinephrine
  • Lidocaine 2% with 1:100 000 epinephrine
Trial Overview The study aims to compare the effectiveness of two local anesthetics—Bupivacaine and Lidocaine—for managing postoperative pain after thyroid surgery. Participants will receive one of these drugs during their procedure to see which one provides better pain relief.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: BupivacaineExperimental Treatment1 Intervention
Group II: LidocaineActive Control1 Intervention

Bupivacaine 0.5% with 1:200 000 epinephrine is already approved in United States, Canada, European Union for the following indications:

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Approved in United States as Bupivacaine for:
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Approved in Canada as Marcaine for:
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Approved in European Union as Bupivacaine for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

St. Joseph's Healthcare Hamilton

Lead Sponsor

Trials
203
Recruited
26,900+

Published Research Related to This Trial

In a study of 435 patients, bupivacaine (0.75% in 8.25% dextrose) demonstrated superior efficacy compared to tetracaine for spinal anesthesia, with only one unsatisfactory anesthesia case in the bupivacaine group versus 19 in the tetracaine group for the lower dose.
Bupivacaine was found to be a safe and reliable option for spinal anesthesia, although tetracaine provided longer motor blockade; adding epinephrine to either anesthetic significantly extended their duration of action.
Spinal anesthesia: bupivacaine compared with tetracaine.Moore, DC.[2013]
In a study of 90 patients undergoing thyroid surgery, bilateral superficial cervical plexus blocks using bupivacaine significantly reduced the proportion of patients requiring morphine for pain management (66% vs 90% for placebo).
Patients receiving bupivacaine also reported lower initial pain scores compared to those receiving a placebo, indicating that this local anesthetic infiltration effectively alleviates postoperative pain, although it may not completely eliminate the need for additional pain relief.
Prevention of postoperative pain after thyroid surgery: a double-blind randomized study of bilateral superficial cervical plexus blocks.Dieudonne, N., Gomola, A., Bonnichon, P., et al.[2022]
In a study of 40 patients undergoing thyroidectomy, those who received intravenous lidocaine during surgery reported significantly lower postoperative pain scores at multiple time points compared to a control group, indicating its efficacy in pain management.
The lidocaine group also required less additional analgesia post-surgery, suggesting that lidocaine not only reduces pain but may also decrease the need for other pain medications.
Analgesic efficacy of Intraoperative lidocaine infusion in patients undergoing thyroidectomy.Akgul, E., Gozeler, MS., Kars, A., et al.[2023]

Citations

Local bupivacaine for postoperative pain management in ...Bilateral superficial cervical plexus block with bupivacaine has been shown to significantly reduce pain intensity in the postoperative period after thyroid ...
Exparel for Post-Surgery Pain Management in Thyroid ...Research shows that using bupivacaine with epinephrine after thyroid surgery can help reduce pain and the need for additional pain medication. This suggests ...
NCT07212114 | Efficacy of EXPAREL vs. BupivacaineThe goal of this clinical study is to learn about pain management strategies in subjects undergoing total ankle replacement. arthroplasty ...
4.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39629142/
The Efficacy of Liposomal Bupivacaine in Thoracic SurgerySecondary outcomes included 24-hour postoperative MMEs, postoperative pain score in the first 24 and 48 hours, hospital length of stay (LOS) ...
Comparing intraoperative administration of long-acting ...This study compared postoperative pain outcomes with LB versus MCs such as ropivacaine-epinephrine-clonidine-ketorolac, bupivacaine-epinephrine-dexamethasone, ...
NCT06271265 | Study to Evaluate the Pharmacokinetics ...This Phase 1, multicenter, open-label, randomized, bupivacaine-controlled study is designed to evaluate the pharmacokinetics (PK) and safety of EXPAREL vs.
Liposomal bupivacaine infiltration for postprocedural ...LB proved to be a safe and likely effective local anesthetic agent, providing prolonged postprocedural analgesia for patients undergoing painful treatments for ...
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