Evaluation of The Efficacy of Bupivacaine Soaked in Gelfoam® at the Iliac Crest Bone Graft Site


Gamli M., Dalgic A., Ornek D., Horasanli E. , Kilci O., Un C., ...More

Revista Brasileira de Anestesiologia, vol.62, no.6, pp.811-819, 2012 (Journal Indexed in SCI Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 62 Issue: 6
  • Publication Date: 2012
  • Doi Number: 10.1016/s0034-7094(12)70181-2
  • Title of Journal : Revista Brasileira de Anestesiologia
  • Page Numbers: pp.811-819
  • Keywords: Bone Transplantation, Bupivacaine, Diskectomy, Gelatin Sponge, Absorbable

Abstract

Background and objective: A substantial number of patients report pain after graft harvest from the anterior iliac crest. This study examined the efficacy of local application of bupivacaine soaked in a Gelfoam® at the bone donor site in controlling postoperative pain and parenteral opioid use. Method: We performed a prospective, double-blind, randomized, placebo-controlled study comparing intraoperative infiltration of 20 mililiters of bupivacaine (treatment, group B) versus saline (placebo), with Gelfoam® soaked into the iliac crest harvest site for patients undergoing elective cervical spinal surgery. Postoperative administration of dihydromorphinone hydrochloride (post anesthesia care unit and patient-controlled analgesia) was standardized. A pain score based on a 10-point visual analog scale (VAS). was used to assess the severity of pain associated with donor site. Pain scores and narcotic use/frequency were recorded at the twenty-four and forty-eighth hour after the operation. Physicians, patients, nursing staff, and statisticians were blinded to the treatment. Results: The groups were similar in baseline age, gender, and comorbidities. There was no significant difference between groups in VAS scores. Narcotic dosage, were significantly less in the Group B at 24 and 48 hours (p < 0.05). Conclusion: This study has demonstrated that bupivacaine soaked in gelfoam at the iliac bone graft harvest site reduced postoperative parenteral opioid usage. © 2012 Elsevier Editora Ltda.