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Local Anesthetic
Steroid-Enhanced Nerve Block vs Exparel for Knee Surgery Pain Management (Yale SEVEN Trial)
Phase 2
Recruiting
Led By Jinlei Li, MD PhD
Research Sponsored by Yale University
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial Must have
American Society of Anesthesiologists status I, II and III, elective, primary, bilateral TKA planned for spinal anesthesia with plain 0.5% bupivacaine.
Be older than 18 years old
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 6 weeks and 3 months
Awards & highlights
Yale SEVEN Trial Summary
This trial evaluates a combo of drugs to see if it's more effective at controlling post-surgical knee pain than another combo.
Who is the study for?
This trial is for adults who are scheduled for elective, primary, bilateral knee replacement surgery and can receive spinal anesthesia with bupivacaine. They should not be pregnant, have coagulopathy or severe liver/renal issues, use opioids recently, or have certain conditions like uncontrolled diabetes.Check my eligibility
What is being tested?
The study compares two pain control methods after knee surgery: one combines dexamethasone and methylprednisolone with bupivacaine (B-DEX-MPA), while the other uses liposomal bupivacaine with plain bupivacaine (B-LB). It aims to see which provides better pain relief and recovery quality.See study design
What are the potential side effects?
Possible side effects include allergic reactions to the medications used in the nerve blocks, increased blood sugar levels from steroids like dexamethasone and methylprednisolone, potential infection at injection site, and general discomfort from nerve block procedure.
Yale SEVEN Trial Eligibility Criteria
Inclusion Criteria
You may be eligible if you check βYesβ for the criteria belowSelect...
I am scheduled for knee replacement surgery under spinal anesthesia.
Yale SEVEN Trial Timeline
Screening ~ 3 weeks3 visits
Treatment ~ Varies
Follow Up ~ 6 weeks and 3 months
Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~6 weeks and 3 months
Treatment Details
Study Objectives
Outcome measures can provide a clearer picture of what you can expect from a treatment.Primary outcome measures
Change in Postoperative Knee Pain Score
Postoperative opioid consumption
Secondary outcome measures
Average Postoperative Knee Pain Score
Change in Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10
Change in Quality of Recovery 40 questionnaire
+10 moreYale SEVEN Trial Design
2Treatment groups
Experimental Treatment
Group I: B-LB in right knee and B-DEX-MPA in left kneeExperimental Treatment2 Interventions
Participants in this arm will receive B-LB in their right knee and B-DEX-MPA in their left knee.
Nerve block with (B-LB): A medication mixture of 40 ml (20 ml LB and 20 ml 0.25% plain bupivacaine) will be prepared, of which 20 ml will be used in Adductor canal block, 10 ml will be used in iPACK block and 5 ml each will be used in medial upper and lateral upper genicular nerve block, respectively.
Nerve block with (B-DEX-MPA): A medication mixture of 40 ml (40 ml 0.25% plain bupivacaine, 10 mg DEX and 80 mg MPA) will be prepared, of which 20 ml will be used in Adductor canal block, 10 ml will be used in iPACK block and 5 ml each will be used in medial upper and lateral upper genicular nerve block, respectively.
Group II: B-LB in left knee and B-DEX-MPA in right kneeExperimental Treatment2 Interventions
Participants in this arm will receive B-LB in their left knee and B-DEX-MPA in their right knee.
Nerve block with (B-LB): A medication mixture of 40 ml (20 ml LB and 20 ml 0.25% plain bupivacaine) will be prepared, of which 20 ml will be used in Adductor canal block, 10 ml will be used in iPACK block and 5 ml each will be used in medial upper and lateral upper genicular nerve block, respectively.
Nerve block with (B-DEX-MPA): A medication mixture of 40 ml (40 ml 0.25% plain bupivacaine, 10 mg DEX and 80 mg MPA) will be prepared, of which 20 ml will be used in Adductor canal block, 10 ml will be used in iPACK block and 5 ml each will be used in medial upper and lateral upper genicular nerve block, respectively.
Research Highlights
Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
Corticosteroids such as dexamethasone sodium phosphate and methylprednisolone acetate reduce inflammation and immune responses, thereby decreasing pain and swelling after Total Knee Arthroplasty (TKA). Local anesthetics like bupivacaine block nerve signals in the surgical area, providing direct pain relief by numbing the tissues.
These treatments are essential for TKA patients as they help manage postoperative pain, reduce the need for narcotics, and improve overall recovery outcomes.
Postoperative intravenous dexamethasone administration: a preliminary investigation.Multiple Treatment Meta-Analysis of Intra-Articular Injection for Temporomandibular Osteoarthritis.Do Corticosteroids Attenuate the Peri-Operative Acute Phase Response After Total Knee Arthroplasty?
Postoperative intravenous dexamethasone administration: a preliminary investigation.Multiple Treatment Meta-Analysis of Intra-Articular Injection for Temporomandibular Osteoarthritis.Do Corticosteroids Attenuate the Peri-Operative Acute Phase Response After Total Knee Arthroplasty?
Find a Location
Who is running the clinical trial?
Yale UniversityLead Sponsor
1,864 Previous Clinical Trials
2,742,199 Total Patients Enrolled
Department of Anesthesiology Faculty Development FundUNKNOWN
1 Previous Clinical Trials
250 Total Patients Enrolled
Jinlei Li, MD PhDPrincipal InvestigatorYale University
1 Previous Clinical Trials
250 Total Patients Enrolled
Media Library
Eligibility Criteria:
This trial includes the following eligibility criteria:- I have not used opioids or regularly used marijuana in the month before my surgery.I have a blood clotting disorder.I have a history of stomach or intestinal issues like ulcers or diverticulitis.I am scheduled for knee replacement surgery under spinal anesthesia.I have a weakened immune system due to a condition like HIV or long-term steroid use.My kidney function is severely impaired.I have diabetes that requires insulin or is not well-controlled.I do not have an infection at the nerve block site or in my body.I have severe nerve pain or damage.I am allergic to or cannot use certain pain relievers and anesthetics.I weigh less than 60 kg.I am having a knee replacement for reasons other than wear and tear arthritis.
Research Study Groups:
This trial has the following groups:- Group 1: B-LB in left knee and B-DEX-MPA in right knee
- Group 2: B-LB in right knee and B-DEX-MPA in left knee
Awards:
This trial has 1 awards, including:- No Placebo-Only Group - All patients enrolled in this study will receive some form of active treatment.
Timeline:
This trial has the following timeline:- Screening: It may take up to 3 Weeks to process to see if you qualify in this trial.
- Treatment: The duration you will receive the treatment varies.
- Follow Ups: You may be asked to continue sharing information regarding the trial for 6 Months after you stop receiving the treatment.
Total Knee Arthroplasty Patient Testimony for trial: Trial Name: NCT05736549 β Phase 2
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