Cowan Naree, Young Jeanne, Murphy Dermot, Bladen Cassi
Department of Nursing Research and Development, Q Block Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, 6009 Australia.
J Neurosci Nurs. 2002 Aug;34(4):205-10. doi: 10.1097/01376517-200208000-00006.
Autogenous iliac crest bone grafts are often used for persons undergoing anterior cervical fusion (ACF). Study findings have shown that pain at the iliac crest donor site can often be more severe than that at the primary operation site. A method used to eliminate pain after bone harvesting involves infiltration of a local anesthetic directly into the site. This study examined the efficacy of local anesthetic infiltration in the control of donor site pain, utilizing a randomized, double-blind, placebo-conrolled design. All participants received standard postoperative intravenous and oral analgesic. Those in the study group also received six injections of bupivacaine hydrochloride 0.25% into the donor site, while participants in the placebo group received normal saline injections. Participants receiving bupivacaine (n = 14) consistently reported lower hip pain scores than participants receiving the placebo (n = 8), with significant differences noted 3 hours after the first and second doses of the study drug. The bupivacaine group's mean morphine intake for the first 24 hours after surgery was found to be lower (32 mg; placebo 44 mg), whereas participants younger than 49 years who received bupivacaine were found, on average, to have stayed in the hospital one day less (3.6 days) than placebo group participants (4.5 days). Younger participants receiving bupivacaine required less morphine and had, on average, a reduced length of stay. The clinical implication of using local anesthetic for the relief of donor site pain suggests that it is a safe and efficacious technique.
自体髂嵴骨移植常用于接受颈椎前路融合术（ACF）的患者。研究结果表明，髂嵴供骨部位的疼痛往往比初次手术部位的疼痛更严重。一种用于消除取骨后疼痛的方法是将局部麻醉剂直接注入该部位。本研究采用随机、双盲、安慰剂对照设计，检验了局部麻醉剂浸润在控制供骨部位疼痛方面的疗效。所有参与者均接受标准的术后静脉和口服镇痛药。研究组的参与者还在供骨部位接受了6次0.25%盐酸布比卡因注射，而安慰剂组的参与者接受了生理盐水注射。接受布比卡因的参与者（n = 14）报告的髋部疼痛评分始终低于接受安慰剂的参与者（n = 8），在首次和第二次注射研究药物后3小时观察到显著差异。布比卡因组术后头24小时的平均吗啡摄入量较低（32毫克；安慰剂组为44毫克），而接受布比卡因的49岁以下参与者平均住院天数比安慰剂组参与者少一天（3.6天对比4.5天）。接受布比卡因的年轻参与者需要的吗啡较少，平均住院时间也缩短了。使用局部麻醉剂缓解供骨部位疼痛的临床意义表明，这是一种安全有效的技术。
