Department of Plastic and Maxillofacial Surgery, Ullevaal University Hospital, Oslo, Kirkeveien 166, 0407 Oslo, Norway.
Anesth Analg. 2010 Apr 1;110(4):1191-4. doi: 10.1213/ANE.0b013e3181cf05f5. Epub 2010 Feb 8.
Deep inferior epigastric perforator flap surgery usually results in postoperative pain from the donor site requiring opioids.
We examined the effect of bupivacaine 2.5 mg/mL, 20 mL given every third hour for 72 hours postoperatively through 2 thin catheters placed on the donor site in a double-blind placebo-controlled study consisting of 2 x 20 patients.
The bupivacaine group had significantly reduced pain at rest and during coughing. The placebo group needed 2 to 3 times more opioids in the 72-hour observation period. No difference was seen in the frequency of nausea or the consumption of antiemetic drugs.
We conclude that intermittent delivery of bupivacaine at the abdominal donor site significantly reduces the postoperative pain and need for narcotic rescue medication.
腹壁下动脉穿支皮瓣手术后通常会引起供区疼痛，需要使用阿片类药物。
我们在一项由 20 例患者组成的双盲安慰剂对照研究中，在供区放置两条细导管，每 3 小时通过导管注入 2.5mg/mL 的布比卡因 20ml，共 72 小时，观察布比卡因对术后疼痛的影响。
布比卡因组在休息和咳嗽时疼痛明显减轻。在 72 小时观察期内，安慰剂组需要 2 到 3 倍的阿片类药物。两组恶心的发生率或止吐药物的使用无差异。
我们的结论是，间断给予腹壁供区布比卡因可显著减轻术后疼痛和对阿片类药物的需求。
