Study of A Long Lasting Local Anesthestic for Hand, Wrist or Finger Surgery

Study Overview
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Brief Summary
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The purpose of this study is to compare Exparel, a new, long-lasting numbing medication and a shorter-acting nerve block to a traditional single-shot nerve block in patients having hand, wrist or finger surgery.

Official Title
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Exparel (Bupivacaine Liposome Injectable Suspension) for Distal Upper Extremity Blocks in Orthopedic Surgery

Conditions
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Hand Injuries, Wrist Injuries, Finger Injuries

Intervention / Treatment
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* Drug: Exparel Forearm block
* Drug: Bupivacaine supraclavicular block


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients 18 years or older having hand, wrist, or finger surgery ability to understand and provide informed consent American Society of Anesthesiologists status I-III presence of a responsible adult caregiver for 48-72 hours after surgery Exclusion Criteria: patient refusal or inability to provide informed consent true allergy, not sensitivity to local anesthetics, midazolam, fentanyl, hydromorphone, propofol pregnancy hepatic or renal failure evidence of infection at or near the proposed needle insertion site any sensorimotor deficit of the upper extremity BMI greater than or equal to 35 uncontrolled or severe pulmonary disease anticoagulant use (not aspirin or non-steroidal anti-inflammatories) chronic pain patients

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exparel forearm block<br>Under ultrasound guidance, 3-5 mL Exparel will be injected around the 3 nerves of the forearm prior to surgery. 20-30 mL Mepivacaine will be used for the supraclavicular block following the forearm block. | Drug: Exparel Forearm block<br>* 20-30 mL Mepivacaine will be used for the supraclavicular block following the forearm block.<br>* Other names: bupivacaine liposome injectable suspension;|
| Active Comparator: Bupivacaine supraclavicular block<br>Under ultrasound guidance, 20-30 mL 0.5% Bupivacaine will be used for the supraclavicular block. | Drug: Bupivacaine supraclavicular block<br>* 20-30mL 0.5% bupivacaine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Onset of Sensorimotor block | A blinded study staff member will evaluate the subject after the block is performed. Subjects will be asked to move their hand and will be asked if they can feel a sharp sensation on specific areas of their hand. Once no movement and no feeling is detected, the block is considered successful and the time will be noted. | 30 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hand surgery, wrist surgery, finger surgery, anesthesia, regional anesthesia, postoperative pain