Page last updated: 2024-10-24

bupivacaine and Surgical Incision

bupivacaine has been researched along with Surgical Incision in 15 studies

Bupivacaine: A widely used local anesthetic agent.
1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide : A piperidinecarboxamide obtained by formal condensation of the carboxy group of N-butylpipecolic acid with the amino group of 2,6-dimethylaniline.
bupivacaine : A racemate composed of equimolar amounts of dextrobupivacaine and levobupivacaine. Used (in the form of its hydrochloride hydrate) as a local anaesthetic.

Research Excerpts

ExcerptRelevanceReference
"To investigate opioid use and pain scores associated with incisional injection of liposomal bupivacaine compared with bupivacaine hydrochloride after laparotomy for gynecologic malignancies."3.83Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies. ( Bakkum-Gamez, JN; Borah, BJ; Cliby, WA; Dowdy, SC; Jankowski, CJ; Kalogera, E; Langstraat, CL; Lovely, JK; Moriarty, JP; Weaver, AL, 2016)
"The reduction in postoperative pain started within 1h after the suturing of the tissues in the treatment group."1.46Local infiltration of the surgical wounds with levobupivacaine, dexibuprofen, and norepinephrine to reduce postoperative pain: A randomized, vehicle-controlled, and preclinical study. ( Cao, X; Cui, F; Gao, Z; Li, T; Li, X; Wang, D, 2017)
"Postoperative pain was assessed by rodent grimace scales scoring."1.46Local infiltration of the surgical wound with levobupivacaine, ibuprofen, and epinephrine in postoperative pain: An experimental study. ( Kapupara, PP; Korat, PS, 2017)
"Substance P levels were similar in the lidocaine and ropivacaine groups but were significantly lower than those of the control group (P = ."1.43Effects of Lidocaine, Bupivacaine, and Ropivacaine on Calcitonin Gene-Related Peptide and Substance P Levels in the Incised Rat Skin. ( Chadi, G; Ferreira, LM; Hochman, B; Lapin, GA; Maximino, JR, 2016)

Research

Studies (15)

TimeframeStudies, this research(%)All Research%
pre-19900 (0.00)18.7374
1990's0 (0.00)18.2507
2000's0 (0.00)29.6817
2010's9 (60.00)24.3611
2020's6 (40.00)2.80

Authors

AuthorsStudies
Power, AM1
McKee, T1
Jordan, K1
Bergman, PJ1
Davis, KM1
Medina-Gallardo, NA1
De Castro, X1
De Caralt-Mestres, E1
Curbelo-Peña, Y1
Dardano-Berriel, A1
Serrat Puyol, J1
Roura-Poch, P1
Vallverdu-Cartie, H1
Jiang, H1
Ma, Q1
Dong, J1
Ye, X1
Aldrich, LA1
Upchurch, DA1
Roush, JK1
Minto, BW1
Zanato, L1
Franco, GG1
Kawamoto, FYK1
Borsaro, CP1
Pazzini, JM1
Carvalho, ER1
Matsui, A1
Ponce de León-Ballesteros, G1
Ramírez-Del Val, A1
Romero-Vélez, G1
Perez-Soto, RH1
Moctezuma, P1
Santes, O1
Ponce de León-Felix, F1
Salgado-Nesme, N1
Gao, Z1
Cui, F1
Cao, X1
Wang, D1
Li, X1
Li, T1
Mismar, AA1
Mahseeri, MI1
Al-Ghazawi, MA1
Obeidat, FW1
Albsoul, MN1
Al-Qudah, MS1
Albsoul, NM1
Korat, PS1
Kapupara, PP1
Zaretsky, M1
Wood, C1
Nivens, T1
McLaughlin, G1
Zuk, J1
Pan, Z1
Chow, F1
Kluge, K1
Larenza Menzies, MP1
Kloeppel, H1
Pearce, SG1
Bettschart-Wolfensberger, R1
Kutter, AP1
Kalchofner Guerrero, KS1
Campagna, I1
Bruhl-Day, R1
Hegamin-Younger, C1
Guerrero, TG1
Lapin, GA1
Hochman, B1
Maximino, JR1
Chadi, G1
Ferreira, LM1
Kalogera, E1
Bakkum-Gamez, JN1
Weaver, AL1
Moriarty, JP1
Borah, BJ1
Langstraat, CL1
Jankowski, CJ1
Lovely, JK1
Cliby, WA1
Dowdy, SC1
Rashid, A1
Gorissen, KJ1
Ris, F1
Gosselink, MP1
Shorthouse, JR1
Smith, AD1
Pandit, JJ1
Lindsey, I1
Crabtree, NA1

Clinical Trials (5)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
Postoperative Analgesia After Cardiac Surgery - A Double-Blind, Prospective and Randomized Comparison of Wound Infiltration With Liposomal Bupivacaine and Bupivacaine Hydrochloride[NCT03270514]Phase 360 participants (Actual)Interventional2018-11-15Completed
The Effect of Local Infiltration of Liposomal Bupivacaine on Opioid Consumption at Time of Cesarean Delivery: A Randomized Controlled Trial[NCT03907813]Phase 40 participants (Actual)Interventional2019-05-01Withdrawn (stopped due to change in design)
Efficacy of Transversus Abdominis Plane (TAP) Block Techniques: A Comparison Between Intraoperative Surgeon Administration by Direct Visualization vs Image Guided Administration by Anesthesiologist, a Prospective Randomized Controlled Trial[NCT03577912]60 participants (Actual)Interventional2015-08-17Completed
Randomized Prospective Study Comparison of Erector Spinae Plane Block and Intrathecal Opioid for Postoperative Analgesia After Laparoscopic Colorectal Surgery in an Enhanced Recovery Setting[NCT05257941]Phase 1/Phase 2126 participants (Anticipated)Interventional2022-01-27Recruiting
TAP Blocks Performed With Bupivacaine Versus Liposomal Bupivacaine in Colorectal Surgery Patients: A Prospective, Cluster Randomized Trial[NCT03638635]Phase 463 participants (Actual)Interventional2018-05-14Terminated (stopped due to Lack of personnel available to complete study.)
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

Hospital Readmission

Readmission to hospital will be noted (NCT03270514)
Timeframe: From end of surgery assessed up to 30 days post-operatively

InterventionParticipants (Count of Participants)
Exparel Injectable Product3
Bupivacaine Hydrochloride3

Mortality

Mortality will be noted at specific timepoints (NCT03270514)
Timeframe: From end of surgery assessed up to 30 days post-operatively

InterventionParticipants (Count of Participants)
Exparel Injectable Product0
Bupivacaine Hydrochloride1

Non-invasive Ventilation (NIV) Requirement

Episodes of NIV such as upper airway masks or similar devices will be quantified (NCT03270514)
Timeframe: From time of end of surgery to 72 hours post-operatively or until hospital discharge

InterventionParticipants (Count of Participants)
Exparel Injectable Product6
Bupivacaine Hydrochloride5

Patient Satisfaction

Patient will give an assessment regarding pain management on a scale of 0 - 10 with 0 indicating the lowest satisfaction with pain management and 10 indicating the highest satisfaction with pain management (NCT03270514)
Timeframe: Given at the time of discharge up to 30 days post-operatively

Interventionscore on a scale (Median)
Exparel Injectable Product10
Bupivacaine Hydrochloride10

Patient Time to Mobilization

The time it takes until patient ambulates will be measured (NCT03270514)
Timeframe: From time of end of surgery to time of mobilization up to 72 hours or discharge, *assessed up to 120 hours*

Interventionhours (Median)
Exparel Injectable Product42
Bupivacaine Hydrochloride45

Patient Time to Oral Intake

The time it takes until the patient is able to/medically cleared to consume food or liquid will be measured (NCT03270514)
Timeframe: From time of end of surgery to time of oral intake up to 72 hours post-operatively or until hospital discharge

Interventionhours (Median)
Exparel Injectable Product7
Bupivacaine Hydrochloride5.6

Patient Time to Out of Bed to Chair

The time it takes until the patient advances from bedrest to out of bed (OOB) to chair will be measured (NCT03270514)
Timeframe: From time of end of surgery to time of mobilization up to 72 hours post-operatively

Interventionhours (Median)
Exparel Injectable Product16
Bupivacaine Hydrochloride16

Post-operative Nausea and Vomiting

Whether a patient experiences at least one episode of nausea and emesis will be measured (NCT03270514)
Timeframe: From time of end of surgery to 72 hours post-operatively

InterventionParticipants (Count of Participants)
Exparel Injectable Product3
Bupivacaine Hydrochloride9

Re-intubation

Instances of re-intubation will be recorded (NCT03270514)
Timeframe: From time of end of surgery to patient discharge up to one week

InterventionParticipants (Count of Participants)
Exparel Injectable Product3
Bupivacaine Hydrochloride3

Time to Extubation

The time it takes until the patient is extubated post-operatively will be measured (NCT03270514)
Timeframe: From the end of surgery until the patient is extubated up to 72 hours post-operatively

Interventionhours (Median)
Exparel Injectable Product3.85
Bupivacaine Hydrochloride3.47

Use of Incentive Spirometry

Frequency of incentive spirometry will be measured (NCT03270514)
Timeframe: From time of end of surgery to 72 hours post-operatively

InterventionParticipants (Count of Participants)
Exparel Injectable Product29
Bupivacaine Hydrochloride31

Length of Hospital and ICU Stay

Length of both hospital and ICU stay will be measured (NCT03270514)
Timeframe: From date of surgery assessed up to 30 day post-operatively

,
Interventiondays (Median)
Length of ICU stayLength of postoperative hospital stay
Bupivacaine Hydrochloride1.716
Exparel Injectable Product1.517

Post-operative Pain Intensity

Postoperative pain scores evaluated by numeric rating scale or (NRS) where 0- no pain and 10- worst pain, at rest and at movement (NCT03270514)
Timeframe: NRS scores will be evaluated every 4 hours until 24 hours post-operatively, every 8 hours until 48 hours post-operatively, and every 12 hours for 72 hours post-operatively

,
Interventionscore on a scale (Mean)
4hrs. at rest4hrs. with movement8hrs. at rest8hrs. with movement12hrs. at rest12hrs. with movement16hrs. at rest16hrs. with movement20hrs. at rest20hrs. with movement24hrs. at rest24hrs. with movement32hrs. at rest32hrs. with movement40hrs. at rest40hrs. with movement48hrs. at rest48hrs. with movement60hrs. at rest60hrs. with movement72hrs. at rest72hrs. with movement
Bupivacaine Hydrochloride5.036.644.9966.64.9626.564.9286.524.8946.484.866.444.7926.324.7246.244.6566.164.5546.044.4525.92
Exparel Injectable Product4.74825.754.72625.744.70425.734.68225.724.66025.714.63825.74.59425.684.52825.664.46225.644.37425.614.28625.58

Serum Cortisol Levels

Stress response suppression as a result of treatment will be evaluated by comparing hormone levels between the groups. Serum cortisol levels will be taken to measure this. (NCT03270514)
Timeframe: Measured 8, 48, and 72 hours post-operatively

,
Interventionµg/dL (Median)
8 hours postoperatively48 hours postoperatively72 hours postoperatively
Bupivacaine Hydrochloride36.51917
Exparel Injectable Product301516

Total Narcotic Consumption

All narcotics administered in the first 0-8, 8-24, 24-48, and 48-72 hours and the total narcotics administered in the 0-72 hours postoperative period(PCA narcotics, nurse-administered IV narcotics, and oral narcotics). All narcotics will be converted to total IV morphine equivalent for comparison between two groups. (NCT03270514)
Timeframe: 0-72 hours post-operative period

,
Interventionoral morphine equivalents in mg (Median)
0-8 hours8-24 hours24-48 hours48-72 hours0-72 hours
Bupivacaine Hydrochloride1034.54526.5105
Exparel Injectable Product15454515139

In-hospital Antiemetic Use

Amount of ondansetron patient required postoperatively during hospital stay, in milligrams (NCT03638635)
Timeframe: Time of transfer to post operative suite to time of discharge (usually up to 4 days after surgery).

Interventionmg (Mean)
Standard Bupivacaine2.9
Bupivacaine Liposome5.6

Length of Stay

Total postoperative hospital stay in days (NCT03638635)
Timeframe: Date of surgery to date of discharge (usually up to 4 days after surgery).

Interventiondays (Median)
Standard Bupivacaine3
Bupivacaine Liposome3.5

Pain Score

Recorded on a scale of 0 (No pain) to 10 (Worst possible pain) (NCT03638635)
Timeframe: Approximately every 6 hours through postoperative day 3 by 1 pm

Interventionunits on a scale (Median)
Standard Bupivacaine3
Bupivacaine Liposome3

Time to Clear Liquid Diet

Number of days from time of surgery until patient tolerates clear liquid diet (NCT03638635)
Timeframe: From time of surgery until first time patient tolerates clear liquids without nausea or vomiting. Assessed until date of discharge (usually up to 4 days after surgery).

Interventiondays (Median)
Standard Bupivacaine0
Bupivacaine Liposome0

Time to Low Fiber Diet

Number of days from day of surgery until patient tolerates low fiber diet (NCT03638635)
Timeframe: From time of surgery until first time patient tolerates a low fiber diet without nausea or vomiting. Assessed until date of discharge (usually up to 4 days after surgery).

Interventiondays (Median)
Standard Bupivacaine1.5
Bupivacaine Liposome1

Time to Patient Mobilization

Number of days from day of surgery until patient mobilization (NCT03638635)
Timeframe: From time of surgery until time of first patient ambulation post op. Assessed until date of discharge (usually up to 4 days after surgery).

Interventiondays (Median)
Standard Bupivacaine1
Bupivacaine Liposome0.5

Time to Return of Bowel Function

Number of days from time of surgery until return of bowel function (NCT03638635)
Timeframe: From time of surgery until first time patient passes gas or stool per rectum or into ostomy bag. Assessed until date of discharge (usually up to 4 days after surgery).

Interventiondays (Median)
Standard Bupivacaine2
Bupivacaine Liposome2

Reviews

1 review available for bupivacaine and Surgical Incision

ArticleYear
The effect of liposomal bupivacaine for surgical wound infiltration: A meta-analysis of randomised controlled trials.
    International wound journal, 2023, Volume: 20, Issue:5

    Topics: Analgesics; Bupivacaine; Humans; Liposomes; Morphine Derivatives; Pain, Postoperative; Randomized Co

2023

Trials

7 trials available for bupivacaine and Surgical Incision

ArticleYear
Infiltration of Bupivacaine and Triamcinolone in Surgical Wounds of Milligan-Morgan Hemorrhoidectomy for Postoperative Pain Control: A Double-Blind Randomized Controlled Trial.
    Diseases of the colon and rectum, 2022, 08-01, Volume: 65, Issue:8

    Topics: Bupivacaine; Hemorrhoidectomy; Humans; Morphine Derivatives; Pain, Postoperative; Retrospective Stud

2022
Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery.
    Veterinary surgery : VS, 2023, Volume: 52, Issue:5

    Topics: Analgesics, Opioid; Animals; Anterior Cruciate Ligament Injuries; Bupivacaine; Dog Diseases; Dogs; O

2023
LAW Trial - The Impact of Local Anesthetics Infiltration in Surgical Wound for Gastrointestinal Procedures (LAW): A Double-Blind, Randomized Controlled Trial.
    Journal of investigative surgery : the official journal of the Academy of Surgical Research, 2022, Volume: 35, Issue:1

    Topics: Abdominal Muscles; Analgesics, Opioid; Anesthetics, Local; Bupivacaine; Humans; Pain, Postoperative;

2022
Wound infiltration with bupivacaine 0.5% with or without adrenaline does not decrease pain after thyroidectomy. A randomized controlled study.
    Saudi medical journal, 2017, Volume: 38, Issue:10

    Topics: Acetaminophen; Adult; Analgesics, Non-Narcotic; Analgesics, Opioid; Anesthetics, Local; Bupivacaine;

2017
Femoral and sciatic nerve blockades and incision site infiltration in rabbits undergoing stifle joint arthrotomy.
    Laboratory animals, 2017, Volume: 51, Issue:1

    Topics: Anesthesia, Local; Anesthetics, Local; Animals; Bupivacaine; Femoral Nerve; Intraoperative Complicat

2017
Intraperitoneal bupivacaine with or without incisional bupivacaine for postoperative analgesia in dogs undergoing ovariohysterectomy.
    Veterinary anaesthesia and analgesia, 2016, Volume: 43, Issue:5

    Topics: Analgesia; Anesthetics, Local; Animals; Bupivacaine; Dogs; Female; Hysterectomy; Injections, Intrape

2016
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017
No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial.
    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, Volume: 19, Issue:7

    Topics: Aged; Anesthetics, Local; Bupivacaine; Colectomy; Double-Blind Method; Female; Humans; Laparoscopy;

2017

Other Studies

7 other studies available for bupivacaine and Surgical Incision

ArticleYear
Incidence and severity of short-term incisional complications after intraoperative local infiltration of liposomal bupivacaine in dogs.
    Veterinary surgery : VS, 2022, Volume: 51, Issue:4

    Topics: Anesthetics, Local; Animals; Bupivacaine; Dog Diseases; Dogs; Incidence; Retrospective Studies; Stif

2022
Topical application of lidocaine or bupivacaine in the healing of surgical wounds in dogs.
    Acta cirurgica brasileira, 2020, Volume: 35, Issue:7

    Topics: Anesthetics, Local; Animals; Bupivacaine; Dogs; Female; Lidocaine; Male; Surgical Wound; Wound Heali

2020
Local infiltration of the surgical wounds with levobupivacaine, dexibuprofen, and norepinephrine to reduce postoperative pain: A randomized, vehicle-controlled, and preclinical study.
    Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2017, Volume: 92

    Topics: Anesthesia, Local; Anesthetics, Local; Animals; Bupivacaine; Drug Evaluation, Preclinical; Drug Ther

2017
Local infiltration of the surgical wound with levobupivacaine, ibuprofen, and epinephrine in postoperative pain: An experimental study.
    Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2017, Volume: 96

    Topics: Analgesics, Non-Narcotic; Anesthesia, Local; Anesthetics, Local; Animals; Bupivacaine; Drug Administ

2017
Continuous local bupivacaine wound infusion with neuraxial morphine reduces opioid consumption after cesarean delivery.
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2019, Volume: 32, Issue:23

    Topics: Acetaminophen; Adult; Analgesia, Epidural; Analgesia, Obstetrical; Analgesics, Opioid; Anesthesia, S

2019
Effects of Lidocaine, Bupivacaine, and Ropivacaine on Calcitonin Gene-Related Peptide and Substance P Levels in the Incised Rat Skin.
    Advances in skin & wound care, 2016, Volume: 29, Issue:4

    Topics: Amides; Anesthetics, Local; Animals; Bupivacaine; Calcitonin Gene-Related Peptide; Lidocaine; Rats;

2016
Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies.
    Obstetrics and gynecology, 2016, Volume: 128, Issue:5

    Topics: Administration, Oral; Analgesia, Patient-Controlled; Analgesics, Opioid; Bupivacaine; Cohort Studies

2016
Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies.
    Obstetrics and gynecology, 2016, Volume: 128, Issue:5

    Topics: Administration, Oral; Analgesia, Patient-Controlled; Analgesics, Opioid; Bupivacaine; Cohort Studies

2016
Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies.
    Obstetrics and gynecology, 2016, Volume: 128, Issue:5

    Topics: Administration, Oral; Analgesia, Patient-Controlled; Analgesics, Opioid; Bupivacaine; Cohort Studies

2016
Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies.
    Obstetrics and gynecology, 2016, Volume: 128, Issue:5

    Topics: Administration, Oral; Analgesia, Patient-Controlled; Analgesics, Opioid; Bupivacaine; Cohort Studies

2016