Single-Shot Exparel Versus Catheters for Pain Control in Lower Extremity Orthopedic Trauma Patients

What this Trial Is About

Researchers are evaluating the pain control effects of a single-shot long-acting local anesthetic called Exparel compared to continuous infusion catheters delivering a short-acting local anesthetic, ropivacaine, in patients undergoing orthopedic surgery for traumatic lower extremity injuries. The study aims to clarify whether Exparel truly provides longer-lasting pain relief up to 72 hours post-operation, as often claimed, by directly comparing it to catheter-based nerve blocks. Participants will receive preoperative adductor and sciatic nerve blocks with either Exparel plus bupivacaine or bupivacaine alone plus catheters delivering continuous ropivacaine infusion through pumps at 8 cc per hour. Injections are administered by anesthesia providers using ultrasound guidance and aseptic techniques. The study includes standard preoperative care with medications like gabapentin, Tylenol, and Toradol or Celebrex. Catheters remain in place postoperatively for continuous local anesthetic delivery in the catheter group. Participants' pain levels will be monitored every 12 hours for up to 72 hours after surgery, and opioid consumption will be tracked daily for three days. The primary measurements focus on postoperative pain scores at set intervals, while secondary outcomes include measuring morphine milligram equivalents on each postoperative day. The study is randomized without masking, and participants will be followed throughout the study duration starting in September 2025 until August 2029.

Single Shot Exparel vs Catheters in Lower Extremity Trauma