Safety and efficacy of extended-release bupivacaine local anaesthetic in open hernia repair: a randomized controlled trial

ANZ J Surg. 2012 Apr;82(4):251-7. doi: 10.1111/j.1445-2197.2011.05754.x. Epub 2011 Jun 24.

Abstract

Background: Pain relief remains a major problem in hernia surgery. SABER-Bupivacaine is an investigational extended-release formulation of bupivacaine in a resorbable matrix, which may provide up to 72 h of local pain relief.

Methods: A double-blinded, randomized controlled trial was undertaken to evaluate the safety and efficacy of SABER-Bupivacaine. Consented patients (n = 124) undergoing open inguinal hernia repair at five sites in Australia and New Zealand were randomized to receive either 2.5 (330 mg) or 5.0 mL (660 mg) of SABER-Bupivacaine or SABER-Placebo administered to the surgical wound at the end of the procedure. Analgesic efficacy and safety was evaluated.

Results: SABER-Bupivacaine appeared safe with no difference in the incidence of side effects compared with SABER-Placebo. The 5.0 mL dose of SABER-Bupivacaine reduced the mean area under the curve of pain intensity on movement compared with SABER-Placebo (2.47 versus 3.60; P = 0.0033) and decreased the number of patients requiring supplemental opioids by 26% (although not statistically significant; P = 0.0909). Normal wound healing was reported throughout the trial and at 3- and 6-month follow-up in every treatment group.

Conclusion: After open inguinal hernia repair, SABER-Bupivacaine administered at the surgical site was safe and provided pain relief, reduced the need for supplemental (oral and parenteral) analgesia and did not impair wound healing.

Trial registration: ClinicalTrials.gov NCT00818363.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anesthesia, General
  • Anesthetics, Local / administration & dosage*
  • Anesthetics, Local / adverse effects
  • Bupivacaine / administration & dosage*
  • Bupivacaine / adverse effects
  • Delayed-Action Preparations
  • Double-Blind Method
  • Female
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / methods
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control
  • Young Adult

Substances

  • Anesthetics, Local
  • Delayed-Action Preparations
  • Bupivacaine

Associated data

  • ClinicalTrials.gov/NCT00818363