scholarly journals Effect of Dexamethasone as an Adjuncton Efficacy of Ropivacaine in Caudal Block forPostoperative Analgesia in Paediatric Infra-Umbilical Surgeries: A Randomised Double-blind Controlled Study

2021 ◽  
Author(s):  
Veena Patodi ◽  
Kavita Jain ◽  
Mukesh Choudhary ◽  
Surendra Kumar Sethi ◽  
Neena Jain ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Controlled Study ◽  
P Value ◽  
Single Shot ◽  
Caudal Block ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Paediatric Patients ◽  
Haemodynamic Changes

Introduction: Caudal block is a routinely performed analgesic and anaesthetic technique in paediatric population undergoing various infra-umbilical surgeries. Various adjuvants have been used along with local anaesthetics like ropivacaine in single-shot caudal block for enhancing postoperative analgesia in paediatric infra-umbilical surgeries. Aim: To evaluate the efficacy of dexamethasone used as an adjuvant to 0.2% ropivacaine in caudal block for postoperative analgesia in paediatric patients. Materials and Methods: This was a randomised doubleblinded controlled study conducted on 80 paediatric patients (8 months-8 years), with American Society of Anesthesiologists (ASA) physical status I or II undergoing various infra-umbilical surgeries,at a tertiary care teaching institute from April 2019 to September 2019. These total subjects were randomly allocated into two groups. GroupR (n=40) administered 0.2% ropivacaine (1 mL/kg) while GroupRD (n=40) administered 0.2% ropivacaine (1 mL/kg) with dexamethasone (0.1 mg/kg) in caudal block. The duration of analgesia, postoperative pain scores (Face Legs Activity Cry Consolability (FLACC) score), rescue analgesic consumption in 24 hours, haemodynamic changes and side-effects were noted. The rescue analgesic (paracetamol 15 mg/kg oral) was given whenever FLACC ≥4. Standard qualitative and quantitative tests (unpaired student t-test, Chi-square test) were used to analyse and compare the results obtained. Results: The mean duration of analgesia was significantly longer in Group RD (745.21±146.91 min) as compared to GroupR (440.38±76.44 min); (p-value <0.001). The significantly lower FLACC pain scores were noted in patients in Group RD compared to Group R; (p-value <0.05). The rescue analgesic consumption was significantly lesser in Group RD in terms of requirement of number of doses of rescue analgesic than in Group R; (p-value <0.05). No significant haemodynamic changes or side-effects were observed in both groups; (p-value >0.05). Amongst postoperative complications noted, fever was observed in 1 patient (3.33%) and PONV in 2 patients (6.66%) in Group R. None complications were observed in the patients of RD group. Conclusion: Dexamethasone (0.1 mg/kg) was found to be safe and effective adjuvant to 0.2% ropivacaine for caudal block in children undergoing various infra-umbilical surgeries.

scholarly journals Intercostal Nerve Block and Peritubal Infiltration with Bupivacaine for Postoperative Analgesia after Percutaneous Nephrolithotomy: A Randomised Clinical Study

2021 ◽  
Author(s):  
Karunakaran Binil ◽  
Kaniyil Suvarna ◽  
Kannammadathy Poulose Biji
Keyword(s):  
Postoperative Pain ◽  
Nerve Block ◽  
Percutaneous Nephrolithotomy ◽  
Postoperative Analgesia ◽  
Intercostal Nerve ◽  
Categorical Variables ◽  
P Value ◽  
Intercostal Nerve Block ◽  
Analgesic Consumption ◽  
Pain Scores

Introduction: Percutaneous Nephrolithotomy (PCNL), a common endourologic procedure for removal of renal stones is associated with significant pain. Regional blocks are being used for postoperative analgesia after PCNL. Aim: To compare the analgesic efficacy of intercostal nerve block and fluoroscopic guided peritubal infiltration in terms of duration of analgesia, postoperative pain scores and total analgesic consumption in first 24 hours. Materials and Methods: This was a randomised clinical trial conducted from May 2018 to October 2018 on total of eighty patients, randomly allocated to two groups of 40 each. Group IC received intercostal nerve block and group IF received fluoroscopy guided peritubal infiltration with 0.25% bupivacaine. Duration of analgesia was assessed from postoperative pain scores (Numerical Rating Scale (NRS) during rest and coughing). Total analgesic consumption for 24 hours was also noted. Data was analysed using Chi-square test for categorical variables and independent Student’s t-test for quantitative variables. Results: The duration of analgesia was 702.00±140.022 minutes in Group IC and 346.50±129.566 minutes in group IF which was significant statistically with a p-value of <0.001. Resting and dynamic NRS were lower upto 12 hours postoperatively in group IC (p-value less than 0.05). Both tramadol (50.00±11.32 mg vs 82.50±24.15 mg) and paracetamol (100±303.82mg vs 850±622.23mg) requirements were lower in group IC as compared to group IF with p-values less than 0.001. Total consumption of first rescue analgesic tramadol as well as second analgesic Paracetamol both were significantly lesser(p-value<0.001) in group IC than group IF. Conclusion: Intercostal Nerve Block (INB) provided superior analgesia compared to fluoroscopic guided peritubal infiltration after PCNL.

scholarly journals Postoperative Analgesic Efficacy of Nalbuphine vs Dexmedetomidine as Adjuvants to Ropivacaine in Ultrasound Guided Transversus Abdominis Plane Block for Abdominal Hysterectomies: A Randomised Clinical Study

2021 ◽  
Author(s):  
Sumanth Tarigonda ◽  
Vishnuvardhan Voleti ◽  
Dinesh Krishnamurthy ◽  
Sheela Shikaripura Rangappa
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
P Value ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Pain Scores ◽  
Patient Reported ◽  
Group D

Introduction: Transversus Abdominis Plane (TAP) block has been practised as an effective alternative to systemic analgesics to achieve adequate postoperative analgesia, with minimal systemic side effects. Dexmedetomidine, an alpha-2 agonist and nalbuphine, an opioid, have been studied as adjuvants to local anaesthetics to improve the analgesic profile of regional anaesthetic blocks. Aim: To compare the duration and quality of postoperative analgesia of dexmedetomidine and nalbuphine when used as adjuvants to ropivacaine for TAP block. Materials and Methods: This was a randomised double blinded study conducted on 60 patients undergoing total abdominal hysterectomies under spinal anaesthesia. Patients were randomly distributed into two groups of 30 patients each, to receive either 39 mL of 0.2% ropivacaine+50 μg dexmedetomidine (1 mL) (group D) or 39 mL of 0.2% ropivacaine+10 mg nalbuphine (1 mL) (group N), for bilateral TAP block. Postoperative pain scores, time for first rescue analgesic request and incidence of side effects were compared. Results: Duration of postoperative analgesia was similar in both groups (409.14±48.92 minutes in group D vs 419.03±54.11 minutes in group N) (p-value=0.462). Postoperative pain scores and total amount of rescue analgesic requirement (105.17±42.98 vs 106.45±46.08) was also similar in both the groups (p=0.912). In Nalbuphine group, 16.7% reported pruritis (p-value=0.02) and 13.3% reported nausea (p-value=0.213). However, in group D only one patient reported nausea two hours postoperatively. Conclusion: Nalbuphine when compared to dexmedetomidine, as an additive to ropivacaine for TAP block, provides similar postoperative analgesic duration and efficacy, but increases the incidence of pruritus and nausea.

Effects of perioperative S (+) ketamine infusion added to multimodal analgesia in patients undergoing ambulatory haemorrhoidectomy

2010 ◽  
Vol 1 (2) ◽  
pp. 100-105 ◽  
Author(s):  
Ulrich J. Spreng ◽  
Vegard Dahl ◽  
Johan Ræder
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Analgesic Effect ◽  
Low Dose ◽  
Isotonic Saline ◽  
Multimodal Analgesia ◽  
Controlled Study ◽  
Double Blind ◽  
Pain Scores ◽  
Pacu Stay

AbstractBackground and objectivePerioperative low-dose ketamine has been useful for postoperative analgesia. In this study we wanted to assess the analgesic effect and possible side-effects of perioperative low-dose S (+) ketamine when added to a regime of non-opioid multimodal pain prophylaxis.MethodsSeventy-seven patients scheduled for haemorrhoidectomy were enrolled in this randomized, double-blind, controlled study. They received oral paracetamol 1–2 g, total intravenous anaesthesia, intravenous 8 mg dexamethasone, 30 mg ketorolac and local infiltration with bupivacaine/epinephrine. Patients randomized to S (+) ketamine received an intravenous bolus dose of 0.35 mg kg−1 S (+) ketamine before start of surgery followed by continuous infusion of 5 μg kg−1 min−1 until 2 min after end of surgery. Patients in the placebo group got isotonic saline (bolus and infusion). BISTM monitoring was used. Pain intensity and side-effects were assessed by blinded nursing staff during PACU stay and by phone 1, 7 and 90 days after surgery.ResultsIn patients randomized to S (+) ketamine emergence from anaesthesia was significantly longer (13.1 min vs. 9.3 min; p < 0.001). BIS values were significantly higher during anaesthesia (maximal value during surgery: 62 vs. 57; p = 0.01) and when opening eyes (81 vs. 70, p < 0.001). Pain scores (NRS and VAS) did not differ significantly between groups.ConclusionsThe addition of perioperative S (+) ketamine for postoperative analgesia after haemorrhoidectomy on top of multimodal non-opioid pain prophylaxis does not seem to be warranted, due to delayed emergence and recovery, more side-effects, altered BIS readings and absence of additive analgesic effect.

scholarly journals Comparative evaluation of caudal tramadol and fentanyl when mixed with bupivacaine in paediatric age group

2020 ◽  
Vol 8 (4) ◽  
pp. 1445
Author(s):  
Abhinav Tewari ◽  
Ajit Kumar Singh
Keyword(s):  
Postoperative Analgesia ◽  
Comparative Evaluation ◽  
Pediatric Patients ◽  
Analgesic Efficacy ◽  
Age Group ◽  
Caudal Block ◽  
Pain Scores ◽  
Haemodynamic Changes ◽  
Paediatric Age ◽  
The Mean

Background: A caudal block is commonly performed block for postoperative analgesia pediatric surgeries. Duration can be enhanced by addition drugs like fentanyl, tramadol, clonidine midazolam etc to local anesthetics helps in decreasing the requirement of postoperative analgesics. This study was conducted to assess the analgesic efficacy of tramadol or fentanyl when mixed with bupivacaine in pediatric patients for surgeries below the umbilicus.Methods: Fifty children of ASA I and ASA status, between 2 to 12 years of age, of both sexes underwent elective surgeries below umbilicus were selected and randomly divided into groups of 25 each. One Group, T (n = 25) received 0.75 ml/kg of 0.25% bupivacaine with tramadol 1mg/ kg and other Group F (n = 25) received 0.75 ml/kg of 0.25% bupivacaine with Inj fentanyl 1μg/kg. Assessment of analgesia and any side effects after caudal injection to the first administration of analgesia were recorded for both the groups in next 24 hours following objective pain scores. Duration of analgesia and requirement of additional rescue analgesics was noted.Results: The Mean duration of analgesia recorded longer in Group T (18.26±6.1 hours) as compared to Group F (10.0+/- 2.68 hrs.) and no significant haemodynamic changes or adverse effect noted between 2 groups.Conclusions: Addition of tramadol, 1mg/kg to bupivacaine 0.25% for caudal anesthesia in children undergoing surgeries below umbilicus, enhances and prolongs postoperative analgesia compared to caudal fentanyl 1μg/kg and bupivacaine 0.25% alone.

scholarly journals Comparison of bupivacaine and bupivacaine plus magnesium sulphate infiltration for postoperative analgesia in patients undergoing lumbar laminectomy: A prospective randomised double-blinded controlled study

2014 ◽  
Vol 01 (03) ◽  
pp. 183-187 ◽  
Author(s):  
Praveen Donadi ◽  
Srilata Moningi ◽  
Ramachandran Gopinath
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Normal Saline ◽  
Magnesium Sulphate ◽  
Controlled Study ◽  
Surgical Trauma ◽  
Analgesic Consumption ◽  
Paravertebral Muscles ◽  
Chi Square Analysis

AbstractBackground: Laminectomy is associated with considerable postoperative pain. Providing analgesia locally in the area of surgical trauma, with minimal systemic side effects, is an attractive option and has become an integral part of multimodal analgesia. The objective of this study was to assess and compare the effectiveness and safety of local infiltration of bupivacaine and bupivacaine plus magnesium sulphate for postoperative analgesia in patients undergoing lumbar laminectomy. Materials and Methods: Sixty adult patients of the American Society of Anaesthesiologists (ASA) class 1 and 2 were randomly allocated into two groups, comprising 30 patients in each group. After the completion of lumbar laminectomy, the study drug was locally infiltrated into the paravertebral muscles on either side. Group bupivacaine with magnesium (BM) was given 20 ml of 0.25% bupivacaine with 500 mg of magnesium sulphate (constituted with normal saline); and Group bupivacaine (B) was given 20 ml of 0.25% bupivacaine constituted with normal saline. Postoperative visual analogue scale (VAS) pain scores at 1, 2, 4, 6, 8, 12 and 24 hours; rescue analgesia, the time to first analgesic consumption, degree of overall patient satisfaction and side effects were recorded. Comparison of continuous data between groups was done using independent T-test. Comparison of nominal data was done using Chi-square analysis and ordinal data using Mann-Whitney test. A P value less than 0.05 was considered significant. Results: Time to first analgesic consumption was significantly longer in BM group (7.78 ± 1.350 hours) compared to B group (4.62 ± 0.997 hours) (P < 0.0001). The consumption of Tramadol was significantly higher in B group (202.5 ± 76.9 mg) compared to BM (117.5 ± 63.4 mg) (P < 0.0001). The degree of overall satisfaction with postoperative pain management on a 4-point satisfaction scale was better in BM group (2.77 ± 0.626) compared to B group (2.0 ± 0.587) (P < 0.001). Conclusion: Wound infiltration with bupivacaine and magnesium sulphate provided better pain control and analgesic effect was more significant, providing effective and safe postoperative analgesia in patients undergoing laminectomy surgeries.

scholarly journals Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

2016 ◽  
Vol 125 (6) ◽  
pp. 1513-1522 ◽  
Author(s):  
Nir Shimony ◽  
Uri Amit ◽  
Bella Minz ◽  
Rachel Grossman ◽  
Marc A. Dany ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sleep Quality ◽  
Rating Scale ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Neurosurgical Patients ◽  
Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

scholarly journals Intermittent Subcutaneous Morphine for Postoperative Analgesia Following Coronary Artery Bypass Grafting

2020 ◽  
Author(s):  
CN Namitha ◽  
Manjunath R Kamath ◽  
Ananda Bangera ◽  
M Gopala Krishnan ◽  
B Amith Kiran
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Side Effects ◽  
Postoperative Pain ◽  
Coronary Artery Bypass ◽  
Postoperative Analgesia ◽  
Artery Bypass ◽  
P Value ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction: An effective postoperative pain management is of utmost importance following cardiac surgery. Various agents, routes and modes are available for the treatment of postoperative pain. Subcutaneous route of administration is an easy and effective method of postoperative analgesia with improved patient satisfaction and lesser side effects compared to intravenous route. Aim: To evaluate the efficacy of Subcutaneous Morphine (SCM) as postoperative analgesia following Coronary Artery Bypass Grafting (CABG). Materials and Methods: This study was designed as a retrospective analytical survey from June 2015 to June 2017. Medical records of all patients over 18 years of age who underwent coronary artery bypass grafting were reviewed. Patients belonging to ASA PS I, II and III, patients above 18 years of age and those posted for coronary artery bypass grafting were included in the study. Patients were divided into two groups: SCM group and Paracetamol (PCT) group, depending on the primary analgesia they received. The two groups were compared using Student’s t-test for normally distributed continuous data or non-parametric tests if the data were not normally distributed. Categorical data were compared by Fisher’s-exact test. The p-values <0.05 were considered statistically significant. Results: A total of 102 records were reviewed, out of which 49 patients received SCM and 53 patients had received PCT as their primary postoperative analgesia. It was observed that PCT group required more additional analgesia (intravenous fentanyl/ tramadol) than SCM group which was statistically significant with p-value of <0.001 and the duration of Cardiac Intensive Care Unit (CICU) stay was more in PCT group with p-value of 0.001. Postoperative side effects were significantly more in PCT group. Conclusion: SCM can be effectively administered intermittently for postoperative analgesia following CABG with similar haemodynamic stability and minimal side effects as compared to intermittent intravenous PCT.

scholarly journals Comparative study of dexmedetomidine and clonidine as an adjunct to levobupivacaine in transversus abdominis plane block in patients undergoing total abdominal hysterectomy: a randomized control study

2019 ◽  
Vol 8 (10) ◽  
pp. 3991
Author(s):  
Bharti Gupta ◽  
Amit Gupta ◽  
R. K. Verma ◽  
Payal Shah
Keyword(s):  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
P Value ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Double Blind ◽  
Randomized Control Study ◽  
Pain Scores ◽  
Randomized Control ◽  
Control Study

Background: Ultrasound guided TAP block is safe, simple and effective method of providing postoperative analgesia in surgeries involving abdominal wall incision by blocking anterior branches of thoracolumbar nerves originating from T6-L1. Our aim to study the efficacy of dexmedetomidine and clonidine as an adjunct to levobupivacaine in ultrasound guided TAP block for postoperative analgesia in patients undergoing TAH.Methods: Prospective, double blind randomized control study. Ninety ASA I and II patients scheduled for TAH were randomly assigned in a double blinded study and divided into three groups. Group L received 18ml of 0.25% levobupivacaine+2ml of NS to make total volume of 20ml on each side. Group LC and Group LD received 18ml of 0.25% levobupivacaine + 1 mcg/kg of clonidine or dexmedetomidine diluted in NS to make total volume of 20ml on each side. USG guided TAP block was given when subarachnoid block level regressed to T10 level. Postoperatively patients were assessed for pain scores, HR, SBP, DBP, nausea vomiting, sedation and satisfaction scores at 0, 2, 4, 6 and 12 and 24 hours. Statistical analysis was performed using SPSS software 17. p value<0.05 was considered significant.Results: Pain scores were significantly lower in LD and LC groups as compared to L group and demand for first rescue analgesic was delayed in LD group (491.50±73.29min) and group LC (268.00±35.47min) as compared to group L (129.17±10.67min). The total number of demand doses in 24 hours were significantly less in group LD (1.00±0.00) followed by group LC (2.03±0.18) and group L (2.77±0.57) respectively. Incidence of hypotension, bradycardia and sedation was more in LD group as compared to LC and L groups.Conclusions: TAP block with dexmetomidine as an adjunct to levobupivacaine provides prolonged postoperative analgesia as compared to clonidine as an adjunct and plain levobupivacaine.

scholarly journals The Effect of Systemic and Regional Use of Magnesium Sulfate on Postoperative Tramadol Consumption in Lumbar Disc Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Melek Demiroglu ◽  
Canan Ün ◽  
Dilsen Hatice Ornek ◽  
Oya Kıcı ◽  
Ali Erdem Yıldırım ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Analgesia ◽  
Lumbar Disc ◽  
Demographic Data ◽  
The Other ◽  
Lumbar Disc Surgery ◽  
Paraspinal Muscles ◽  
Pain Scores ◽  
Disc Surgery ◽  
C 30

Aim.To investigate the effect of magnesium administered to the operative region muscle and administered systemically on postoperative analgesia consumption after lumbar disc surgery.Material and Method.The study included a total of 75 ASA I-II patients aged 18–65 years. The patients were randomly allocated into 1 of 3 groups of 25: the Intravenous (IV) Group, the Intramuscular (IM) Group, and the Control (C) Group. At the stage of suturing the surgical incision site, the IV Group received 50 mg/kg MgSO4intravenously in 150 mL saline within 30 mins. In the IM Group, 50 mg/kg MgSO4in 30 mL saline was injected intramuscularly into the paraspinal muscles. In Group C, 30 mL saline was injected intramuscularly into the paraspinal muscles. After operation patients in all 3 groups were given 100 mg tramadol and 10 mg metoclopramide and tramadol solution was started intravenously through a patient-controlled analgesia device. Hemodynamic changes, demographic data, duration of anesthesia and surgery, pain scores (NRS), the Ramsay sedation score (RSS), the amount of analgesia consumed, nausea- vomiting, and potential side effects were recorded.Results.No difference was observed between the groups. Nausea and vomiting side effects occurred at a rate of 36% in Group C, which was a significantly higher rate compared to the other groups (p<0.05). Tramadol consumption in the IM Group was found to be significantly lower than in the other groups (p<0.05).Conclusion.Magnesium applied to the operative region was found to be more effective on postoperative analgesia than systemically administered magnesium.

scholarly journals Regional Anesthetic Blocks for Donor Site Pain in Burn Patients: A Meta-Analysis on Efficacy, Outcomes, and Cost

2020 ◽  
Vol 28 (4) ◽  
pp. 222-231
Author(s):  
Katherine A. Grunzweig ◽  
Ji Son ◽  
Anand R. Kumar
Keyword(s):  
Side Effects ◽  
Regional Anesthesia ◽  
Meta Analysis ◽  
Donor Site ◽  
Single Shot ◽  
Burn Patients ◽  
Pain Scores ◽  
Donor Site Pain ◽  
Graft Donor ◽  
Site Pain

Background: Skin graft donor site pain significantly affects pain management, narcotic use, and hospital length of stay. This study is intended to evaluate the efficacy of regional anesthesia in the burn population to decrease narcotic consumption and to assess the impact on hospitalization costs. Methods: PubMed/MEDLINE, Embase, and ScienceDirect were searched with the following inclusion criteria: comparative studies, adult populations, burn patients, autologous skin grafting, regional nerve blocks, and traditional narcotic regimens. Outcomes assessed included narcotic consumption, pain scores, and opioid side effects. Meta-analysis obtained pooled values for morphine consumption and side effects. Cost analysis was performed using published data in the literature. Results: Final analysis included 101 patients. Cumulative morphine consumption at 72 hours was lower for patients treated with regional anesthesia versus patient-controlled analgesia (PCA; single shot 25 ± 12 mg, continuous regional 23 ± 16 mg, control 91.5 ± 24.5 mg; P < .05). Regional anesthesia decreased nausea/vomiting ( P < .05) and lowered subjective pain scores. Regional anesthesia interventions cost less than PCA, single shot less than continuous ( P < .05). Conclusion: Regional anesthesia at skin graft donor sites significantly decreases narcotic consumption in burn patients. Regional anesthesia is cost-effective, decreases side effects, and may result in shorter hospital stays due to improved pain management.

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