Gbolahan Olalere Omoyosola, Osinaike Babatunde Babasola, Olusanya Adeola Olanike, Okunola Michael Oluyinka
Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria.
Department of Anaesthesia, College of Medicine, University of Ibadan/UCH, Ibadan, Nigeria.
Niger J Surg. 2020 Jul-Dec;26(2):135-141. doi: 10.4103/njs.NJS_68_19. Epub 2020 Jul 27.
Postoperative donor site pain remains a major source of morbidity following iliac crest bone graft harvesting (ICBGH).
The aim of this study was to investigate the effect of single-dose infiltration of bupivacaine on donor site pain following ICBGH.
This study was a double-blind randomized controlled trial of 30 adult individuals that required an ICBG as part of the treatment for mandibular reconstruction. Individuals were divided into two groups, to receive a single-dose subcutaneous infiltration of either 0.25% bupivacaine or 0.9% normal saline at the iliac crest graft incision site following ICBGH. Length of incision at the ICBGH site, dimensions of harvested graft, time taken for the iliac crest harvest surgery, total daily dose of postoperative analgesics, pain from the ICBGH site as well as gait disturbance were recorded. Data were analyzed using SPSS version 17.0, and < 0.05 was considered statistically significant.
There was a progressive decrease in pain score from the 1 to the 4 postoperative day, with no significant difference between the two groups. There was no statistical difference between the two groups in terms of dynamic median pain score at the early postoperative period as well as at the 4 and 12 week postoperative period. The analgesic consumption between the two groups also did not show any significant difference.
Local injection of single dose of 0.25% bupivacaine did not offer additional benefit in the management of postoperative iliac crest donor site pain following ICBGH.
术后供区疼痛仍是髂嵴骨移植术(ICBGH)后发病的主要原因。
本研究旨在探讨布比卡因单剂量浸润对ICBGH后供区疼痛的影响。
本研究为双盲随机对照试验,纳入30例因下颌骨重建需要进行ICBG的成年个体。个体被分为两组,在ICBGH后于髂嵴移植切口部位接受0.25%布比卡因或0.9%生理盐水的单剂量皮下浸润。记录ICBGH部位的切口长度、采集的移植物尺寸、髂嵴采集手术所需时间、术后镇痛药的每日总剂量、ICBGH部位的疼痛以及步态障碍。使用SPSS 17.0版软件进行数据分析,P<0.05被认为具有统计学意义。
术后第1天至第4天疼痛评分逐渐下降,两组间无显著差异。两组在术后早期以及术后第4周和第12周的动态中位疼痛评分方面无统计学差异。两组间的镇痛药消耗量也未显示出任何显著差异。
局部注射单剂量0.25%布比卡因在ICBGH后髂嵴供区术后疼痛管理中未提供额外益处。