Bupivacaine for Post-operative Pain in Mohs

• Status: Completed
• Trial end date: 2021-09-30
• Target enrollment: 0
• Participant gender: All

Summary

Mohs micrographic surgery (MMS) is regarded as the gold standard for the treatment of high-risk nonmelanoma skin cancer (NMSC). Pain after MMS peaks on the day of surgery and slowly decreases thereafter. The most common post-operative analgesics include acetaminophen, ibuprofen and narcotics. Lidocaine is the most commonly used anesthetic in MMS, but bupivacaine has been shown in other surgical specialties to be an effective adjuvant to reduce post-operative pain and opioid use when injected locally in the immediate postoperative period. Bupivacaine has also been shown to reduce intra-operative pain during MMS. The investigators plan a single-blinded prospective, randomized, controlled trial to determine if post-operative wound infiltration of bupivacaine versus normal saline improves post-operative pain and decreases need for post-operative pain medications including both narcotic and nonnarcotic analgesics.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: University of Missouri-Columbia
• Collaborators: Columbia University; University of Pennsylvania
• Treatments: Bupivacaine

Criteria

Inclusion Criteria:

• a. Adult (18 years or older) patients being treated with Mohs micrographic surgery will be included in this study.

b. Surgical procedure must include one of the following:

1. Scalp rotation/transposition/advancement flap

2. Ear rotation/transposition/advancement/interpolation flap or wedge repair

3. Nose rotation/transposition/advancement/interpolation flap, cartilage alar-batten graft (ear donor site)

4. Cheek Mustarde flap

5. Lip rotation/transposition/advancement flap, wedge repair, Abbe flap

Exclusion Criteria:

• c. Patients must not

1. be pregnant or breastfeeding

2. be taking scheduled narcotic medications

3. use narcotics as a drug of abuse

4. have an allergy to bupivacaine or other amide anesthetics

5. have a contraindication to tramadol

6. have been given narcotic pain medications during the Mohs procedure or subsequent reconstruction

7. have multiple surgical sites treated on the same day