Evaluation of the Safety and Efficacy of EXPAREL When Administered Into the TAP in Subjects Undergoing Cesarean Section
Condition: Pain
Intervention: Intrathecal morphine injection; EXPAREL
Intervention description: 0.2 mg; 266 mg
Intervention MeSH terms: Morphine; Bupivacaine
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 12.0
Sex: Female
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This is a Phase 4, multicenter, open-label study evaluating EXPAREL infiltration into the
      transversus abdominis plane (TAP) after bupivacaine hydrochloride (HCl) spinal anesthesia in
      subjects undergoing elective Cesarean section (C-section).
    

Eligibility criteria:

        Inclusion Criteria:

          1. Females ≥18 years of age at screening.

          2. Scheduled to undergo elective C-section (single or multiple births).

          3. American Society of Anesthesiology (ASA) physical status 1, 2, or 3.

          4. Able to provide informed consent, adhere to the study visit schedule, and complete all
             study assessments.

        Exclusion Criteria:

          1. History of hypersensitivity or idiosyncratic reaction to amide-type local anesthetics
             or opioids.

          2. Contraindication to bupivacaine, morphine, ketorolac, ibuprofen, or acetaminophen.

          3. Planned concurrent surgical procedure with the exception of salpingo-oophorectomy or
             tubal ligation.

          4. Use of any of the following medications within the times specified before surgery:
             long-acting opioid medication, non-steroidal anti-inflammatory drugs (NSAIDs), or
             aspirin (except for low-dose aspirin used for cardioprotection) within 3 days, or any
             opioid medication or acetaminophen within 24 hours.

          5. Initiation of treatment with any of the following medications within 1 month of study
             drug administration or if the medication(s) are being given to control pain: selective
             serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors
             (SNRIs), gabapentin, pregabalin (Lyrica®), or duloxetine (Cymbalta®). If a subject is
             taking one of these medications for a reason other than pain control, she must be on a
             stable dose for at least 1 month prior to study drug administration.

          6. Clinically significant medical or psychiatric disease that, in the opinion of the
             Investigator, would constitute a contraindication to participation in the study or
             cause inability to comply with the study requirements.

          7. History of, suspected, or known addiction to or abuse of illicit drug(s), prescription
             medication(s), or alcohol within the past 2 years.

          8. Received an investigational drug within 30 days prior to study drug administration,
             and/or has planned administration of another investigational product or procedure
             while participating in this study.

          9. Previous participating in an EXPAREL study.

             The subject will be withdrawn from the study if she meets the following criteria:

         10. Any clinically significant event or condition uncovered during the surgery (e.g.,
             excessive bleeding, acute sepsis) that might render the subject medically unstable or
             complicate the subject's postsurgical course.

         11. Her baby's 5-minute Apgar score is ≤7.