Postoperative Pain Atskin Graft Site Clinical Trial
Official title:
Comparison of Bupivacaine Versus Bupivacaine-dexamethasone Infiltration for Postoperative Analgesia in Skin Graft Donor Sites, a Randomized Trial
Background: Skin grafting; both partial and complete thickness is frequently used in
reconstruction of traumatic soft tissue defects. It is of great value not only for functional
and aesthetic purposes in the field of plastic surgery, but also for other surgical
specialties.
Of all the problems in the early postoperative period, pain is considered the most important,
ameliorating it can lead to significant reduction in postoperative morbidity and faster
recovery of the skin donor site.
Objective: To evaluate use of dexamethasone as adjuvant for bupivacaine in subcutaneous local
anesthesia infiltration for skin graft donor sites, on quality of pain relief and total dose
of analgesic requirements in the early hours postoperatively.
Methods: 97 patients were randomly allocated to receive local bupivacaine infiltration (group
LB), or dexamethasone plus bupivacaine (group LB + D) in skin donor site after skin
harvesting. In addition to basic demographic data; patients were compared for Numerical
Rating Scale (NRS), total dose of morphine or morphine equivalents, time to 1st breakthrough
pain, and duration of surgery.
Keywords: Donor site. skin graft. Breakthrough pain. Rescue analgesia. Bupivacaine
The patients included in the study were randomly allocated to 1 of 2 parallel groups: 1) bupivacaine plus dexamethasone (LB+D) group (n = 50): received 20 ml bupivacaine 0.5% + 18 ml normal saline + 8 mg dexamethasone 2 ml, 2) bupivacaine only (LB) group (n = 50): received 20 ml bupivacaine 0.5% + 20 ml normal saline. A random allocation sequence was generated electronically using online randomization service from https://www.random.org. The project medicine was prepared by 2 independent assistants not involved in other parts of the study. All persons involved were blinded to the randomized allocation. ;