Analysis of Postoperative Pain at the Anterior Iliac Crest Harvest Site: A Prospective Study of the Intraoperative Local Administration of Ropivacaine
Identifieur interne : 005871 ( Ncbi/Merge ); précédent : 005870; suivant : 005872Analysis of Postoperative Pain at the Anterior Iliac Crest Harvest Site: A Prospective Study of the Intraoperative Local Administration of Ropivacaine
Auteurs : Juliane Zenner [Allemagne] ; Wolfgang Hitzl [Autriche] ; Michael Mayer [Allemagne] ; Heiko Koller [Allemagne]Source :
- Asian Spine Journal [ 1976-1902 ] ; 2015.
Abstract
This was a prospective randomized comparative study.
The aim of this study was to objectify donor site-related pain following anterior iliac crest graft harvesting, in patients who have undergone multilevel anterior cervical discectomy and fusion with plating (ACDFP); and to assess the effect of an intraoperative local single injection of ropivacaine on postoperative pain.
Multilevel ACDFP can be associated with a high non-union rate. Autogenous iliac bone has been used to increase union rates, although a high incidence of donor site-related pain has been reported.
Forty consecutive patients who required 3-level or 4-level ACDFP were prospectively assessed for donor site-related pain. Pain levels were assessed daily for five days postoperative using the visual analog scale (VAS). Patients were randomly assigned to group A or B. In group A patients, 7-10 mL of ropivacaine (0.2%) was injected into the iliac crest after iliac crest graft harvesting. Morphine usage via patient controlled analgesia was calculated. At six months postoperative, patient complaints at the harvest site were documented.
Patients were randomly assigned to group A or B. In group A, ropivacaine was locally administered at the site of the iliac crest graft harvest after fascia closure. In group B, no additional treatments were administered. The average patient age in group A was 56±7.6 years, whereas the average age of patients in group B was 52.6±10.4 years. Group A had an average of 0.6±0.7 previous surgeries per patient, whereas group B had an average of 0.8±1.0 previous surgeries per patient. The average number of levels fused in group A was 3.6±0.7, whereas the average number of levels fused in group B was 3.7±0.9 (all
VAS assessment showed overall moderate perioperative morbidity in terms of donor site-related pain, which was reduced by administering ropivacaine.
Url:
DOI: 10.4184/asj.2015.9.1.39
PubMed: 25705333
PubMed Central: 4330217
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 002846
- to stream Pmc, to step Curation: 002846
- to stream Pmc, to step Checkpoint: 001027
Links to Exploration step
PMC:4330217Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Analysis of Postoperative Pain at the Anterior Iliac Crest Harvest Site: A Prospective Study of the Intraoperative Local Administration of Ropivacaine</title><author><name sortKey="Zenner, Juliane" sort="Zenner, Juliane" uniqKey="Zenner J" first="Juliane" last="Zenner">Juliane Zenner</name><affiliation wicri:level="1"><nlm:aff id="A1">German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen</wicri:regionArea><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion></affiliation></author><author><name sortKey="Hitzl, Wolfgang" sort="Hitzl, Wolfgang" uniqKey="Hitzl W" first="Wolfgang" last="Hitzl">Wolfgang Hitzl</name><affiliation wicri:level="1"><nlm:aff id="A2">Biostatistics, Research Office, Paracelsus Medical University Salzburg, Salzburg, Austria.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Autriche</country><wicri:regionArea>Biostatistics, Research Office, Paracelsus Medical University Salzburg, Salzburg</wicri:regionArea><wicri:noRegion>Salzburg</wicri:noRegion></affiliation></author><author><name sortKey="Mayer, Michael" sort="Mayer, Michael" uniqKey="Mayer M" first="Michael" last="Mayer">Michael Mayer</name><affiliation wicri:level="1"><nlm:aff id="A1">German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen</wicri:regionArea><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion></affiliation></author><author><name sortKey="Koller, Heiko" sort="Koller, Heiko" uniqKey="Koller H" first="Heiko" last="Koller">Heiko Koller</name><affiliation wicri:level="1"><nlm:aff id="A1">German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen</wicri:regionArea><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25705333</idno><idno type="pmc">4330217</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330217</idno><idno type="RBID">PMC:4330217</idno><idno type="doi">10.4184/asj.2015.9.1.39</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">002846</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002846</idno><idno type="wicri:Area/Pmc/Curation">002846</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002846</idno><idno type="wicri:Area/Pmc/Checkpoint">001027</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001027</idno><idno type="wicri:Area/Ncbi/Merge">005871</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Analysis of Postoperative Pain at the Anterior Iliac Crest Harvest Site: A Prospective Study of the Intraoperative Local Administration of Ropivacaine</title><author><name sortKey="Zenner, Juliane" sort="Zenner, Juliane" uniqKey="Zenner J" first="Juliane" last="Zenner">Juliane Zenner</name><affiliation wicri:level="1"><nlm:aff id="A1">German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen</wicri:regionArea><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion></affiliation></author><author><name sortKey="Hitzl, Wolfgang" sort="Hitzl, Wolfgang" uniqKey="Hitzl W" first="Wolfgang" last="Hitzl">Wolfgang Hitzl</name><affiliation wicri:level="1"><nlm:aff id="A2">Biostatistics, Research Office, Paracelsus Medical University Salzburg, Salzburg, Austria.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Autriche</country><wicri:regionArea>Biostatistics, Research Office, Paracelsus Medical University Salzburg, Salzburg</wicri:regionArea><wicri:noRegion>Salzburg</wicri:noRegion></affiliation></author><author><name sortKey="Mayer, Michael" sort="Mayer, Michael" uniqKey="Mayer M" first="Michael" last="Mayer">Michael Mayer</name><affiliation wicri:level="1"><nlm:aff id="A1">German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen</wicri:regionArea><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion></affiliation></author><author><name sortKey="Koller, Heiko" sort="Koller, Heiko" uniqKey="Koller H" first="Heiko" last="Koller">Heiko Koller</name><affiliation wicri:level="1"><nlm:aff id="A1">German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Allemagne</country><wicri:regionArea>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen</wicri:regionArea><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion><wicri:noRegion>Bad Wildungen</wicri:noRegion></affiliation></author></analytic><series><title level="j">Asian Spine Journal</title><idno type="ISSN">1976-1902</idno><idno type="eISSN">1976-7846</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Study Design</title><p>This was a prospective randomized comparative study.</p></sec><sec><title>Purpose</title><p>The aim of this study was to objectify donor site-related pain following anterior iliac crest graft harvesting, in patients who have undergone multilevel anterior cervical discectomy and fusion with plating (ACDFP); and to assess the effect of an intraoperative local single injection of ropivacaine on postoperative pain.</p></sec><sec><title>Overview of Literature</title><p>Multilevel ACDFP can be associated with a high non-union rate. Autogenous iliac bone has been used to increase union rates, although a high incidence of donor site-related pain has been reported.</p></sec><sec><title>Methods</title><p>Forty consecutive patients who required 3-level or 4-level ACDFP were prospectively assessed for donor site-related pain. Pain levels were assessed daily for five days postoperative using the visual analog scale (VAS). Patients were randomly assigned to group A or B. In group A patients, 7-10 mL of ropivacaine (0.2%) was injected into the iliac crest after iliac crest graft harvesting. Morphine usage via patient controlled analgesia was calculated. At six months postoperative, patient complaints at the harvest site were documented.</p></sec><sec><title>Results</title><p>Patients were randomly assigned to group A or B. In group A, ropivacaine was locally administered at the site of the iliac crest graft harvest after fascia closure. In group B, no additional treatments were administered. The average patient age in group A was 56±7.6 years, whereas the average age of patients in group B was 52.6±10.4 years. Group A had an average of 0.6±0.7 previous surgeries per patient, whereas group B had an average of 0.8±1.0 previous surgeries per patient. The average number of levels fused in group A was 3.6±0.7, whereas the average number of levels fused in group B was 3.7±0.9 (all <italic>p</italic>>0.05). In group A, the mean ropivacaine volume administered was 8.4±1.5 mL. No patient complaints regarding chronic pain, were reported six months postoperatively. No complications were encountered from the harvest site, and all patients underwent successful 3-level and 4-level ACDFP. Statistical analysis showed significant differences for VAS on postoperative day 1 (<italic>p</italic>=0.004) and day 2 (<italic>p</italic>=0.005).</p></sec><sec><title>Conclusions</title><p>VAS assessment showed overall moderate perioperative morbidity in terms of donor site-related pain, which was reduced by administering ropivacaine.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Koller, H" uniqKey="Koller H">H Koller</name></author><author><name sortKey="Hempfing, A" uniqKey="Hempfing A">A Hempfing</name></author><author><name sortKey="Ferraris, L" uniqKey="Ferraris L">L Ferraris</name></author><author><name sortKey="Maier, O" uniqKey="Maier O">O Maier</name></author><author><name sortKey="Hitzl, W" uniqKey="Hitzl W">W Hitzl</name></author><author><name sortKey="Metz Stavenhagen, P" uniqKey="Metz Stavenhagen P">P Metz-Stavenhagen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brazenor, Ga" uniqKey="Brazenor G">GA Brazenor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chau, Am" uniqKey="Chau A">AM Chau</name></author><author><name sortKey="Mobbs, Rj" uniqKey="Mobbs R">RJ Mobbs</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fineberg, Sj" uniqKey="Fineberg S">SJ Fineberg</name></author><author><name sortKey="Ahmadinia, K" uniqKey="Ahmadinia K">K Ahmadinia</name></author><author><name sortKey="Oglesby, M" uniqKey="Oglesby M">M Oglesby</name></author><author><name sortKey="Patel, Aa" uniqKey="Patel A">AA Patel</name></author><author><name sortKey="Singh, K" uniqKey="Singh K">K Singh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lu, Dc" uniqKey="Lu D">DC Lu</name></author><author><name sortKey="Tumialan, Lm" uniqKey="Tumialan L">LM Tumialan</name></author><author><name sortKey="Chou, D" uniqKey="Chou D">D Chou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Perri, B" uniqKey="Perri B">B Perri</name></author><author><name sortKey="Cooper, M" uniqKey="Cooper M">M Cooper</name></author><author><name sortKey="Lauryssen, C" uniqKey="Lauryssen C">C Lauryssen</name></author><author><name sortKey="Anand, N" uniqKey="Anand N">N Anand</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fehlings, Mg" uniqKey="Fehlings M">MG Fehlings</name></author><author><name sortKey="Arvin, B" uniqKey="Arvin B">B Arvin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Floyd, T" uniqKey="Floyd T">T Floyd</name></author><author><name sortKey="Ohnmeiss, D" uniqKey="Ohnmeiss D">D Ohnmeiss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hu, R" uniqKey="Hu R">R Hu</name></author><author><name sortKey="Hearn, T" uniqKey="Hearn T">T Hearn</name></author><author><name sortKey="Yang, J" uniqKey="Yang J">J Yang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuhns, Ca" uniqKey="Kuhns C">CA Kuhns</name></author><author><name sortKey="Geck, Mj" uniqKey="Geck M">MJ Geck</name></author><author><name sortKey="Wang, Jc" uniqKey="Wang J">JC Wang</name></author><author><name sortKey="Delamarter, Rb" uniqKey="Delamarter R">RB Delamarter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kaiser, Mg" uniqKey="Kaiser M">MG Kaiser</name></author><author><name sortKey="Mummaneni, Pv" uniqKey="Mummaneni P">PV Mummaneni</name></author><author><name sortKey="Matz, Pg" uniqKey="Matz P">PG Matz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Skeppholm, M" uniqKey="Skeppholm M">M Skeppholm</name></author><author><name sortKey="Olerud, C" uniqKey="Olerud C">C Olerud</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Carragee, Ej" uniqKey="Carragee E">EJ Carragee</name></author><author><name sortKey="Hurwitz, El" uniqKey="Hurwitz E">EL Hurwitz</name></author><author><name sortKey="Weiner, Bk" uniqKey="Weiner B">BK Weiner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Covani, U" uniqKey="Covani U">U Covani</name></author><author><name sortKey="Ricci, M" uniqKey="Ricci M">M Ricci</name></author><author><name sortKey="Santini, S" uniqKey="Santini S">S Santini</name></author><author><name sortKey="Mangano, F" uniqKey="Mangano F">F Mangano</name></author><author><name sortKey="Barone, A" uniqKey="Barone A">A Barone</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hu, Rw" uniqKey="Hu R">RW Hu</name></author><author><name sortKey="Bohlman, Hh" uniqKey="Bohlman H">HH Bohlman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Guha, Sc" uniqKey="Guha S">SC Guha</name></author><author><name sortKey="Poole, Md" uniqKey="Poole M">MD Poole</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ebraheim, Na" uniqKey="Ebraheim N">NA Ebraheim</name></author><author><name sortKey="Yang, H" uniqKey="Yang H">H Yang</name></author><author><name sortKey="Lu, J" uniqKey="Lu J">J Lu</name></author><author><name sortKey="Biyani, A" uniqKey="Biyani A">A Biyani</name></author><author><name sortKey="Yeasting, Ra" uniqKey="Yeasting R">RA Yeasting</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jones, Aa" uniqKey="Jones A">AA Jones</name></author><author><name sortKey="Dougherty, Pj" uniqKey="Dougherty P">PJ Dougherty</name></author><author><name sortKey="Sharkey, Na" uniqKey="Sharkey N">NA Sharkey</name></author><author><name sortKey="Benson, Dr" uniqKey="Benson D">DR Benson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wai, Ek" uniqKey="Wai E">EK Wai</name></author><author><name sortKey="Sathiaseelan, S" uniqKey="Sathiaseelan S">S Sathiaseelan</name></author><author><name sortKey="O Neil, J" uniqKey="O Neil J">J O'Neil</name></author><author><name sortKey="Simchison, Bl" uniqKey="Simchison B">BL Simchison</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sasso, Rc" uniqKey="Sasso R">RC Sasso</name></author><author><name sortKey="Lehuec, Jc" uniqKey="Lehuec J">JC LeHuec</name></author><author><name sortKey="Shaffrey, C" uniqKey="Shaffrey C">C Shaffrey</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cricchio, G" uniqKey="Cricchio G">G Cricchio</name></author><author><name sortKey="Lundgren, S" uniqKey="Lundgren S">S Lundgren</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Estebe, Jp" uniqKey="Estebe J">JP Estebe</name></author><author><name sortKey="Le Corre, P" uniqKey="Le Corre P">P Le Corre</name></author><author><name sortKey="Le Naoures, A" uniqKey="Le Naoures A">A Le Naoures</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dashow, Je" uniqKey="Dashow J">JE Dashow</name></author><author><name sortKey="Lewis, Cw" uniqKey="Lewis C">CW Lewis</name></author><author><name sortKey="Hopper, Ra" uniqKey="Hopper R">RA Hopper</name></author><author><name sortKey="Gruss, Js" uniqKey="Gruss J">JS Gruss</name></author><author><name sortKey="Egbert, Ma" uniqKey="Egbert M">MA Egbert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, K" uniqKey="Singh K">K Singh</name></author><author><name sortKey="Phillips, Fm" uniqKey="Phillips F">FM Phillips</name></author><author><name sortKey="Kuo, E" uniqKey="Kuo E">E Kuo</name></author><author><name sortKey="Campbell, M" uniqKey="Campbell M">M Campbell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ouaki, J" uniqKey="Ouaki J">J Ouaki</name></author><author><name sortKey="Dadure, C" uniqKey="Dadure C">C Dadure</name></author><author><name sortKey="Bringuier, S" uniqKey="Bringuier S">S Bringuier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morgan, Sj" uniqKey="Morgan S">SJ Morgan</name></author><author><name sortKey="Jeray, Kj" uniqKey="Jeray K">KJ Jeray</name></author><author><name sortKey="Saliman, Lh" uniqKey="Saliman L">LH Saliman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chiono, J" uniqKey="Chiono J">J Chiono</name></author><author><name sortKey="Bernard, N" uniqKey="Bernard N">N Bernard</name></author><author><name sortKey="Bringuier, S" uniqKey="Bringuier S">S Bringuier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barkhuysen, R" uniqKey="Barkhuysen R">R Barkhuysen</name></author><author><name sortKey="Meijer, Gj" uniqKey="Meijer G">GJ Meijer</name></author><author><name sortKey="Soehardi, A" uniqKey="Soehardi A">A Soehardi</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Asian Spine J</journal-id><journal-id journal-id-type="iso-abbrev">Asian Spine J</journal-id><journal-id journal-id-type="publisher-id">ASJ</journal-id><journal-title-group><journal-title>Asian Spine Journal</journal-title></journal-title-group><issn pub-type="ppub">1976-1902</issn><issn pub-type="epub">1976-7846</issn><publisher><publisher-name>Korean Society of Spine Surgery</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25705333</article-id><article-id pub-id-type="pmc">4330217</article-id><article-id pub-id-type="doi">10.4184/asj.2015.9.1.39</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical Study</subject></subj-group></article-categories><title-group><article-title>Analysis of Postoperative Pain at the Anterior Iliac Crest Harvest Site: A Prospective Study of the Intraoperative Local Administration of Ropivacaine</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Zenner</surname><given-names>Juliane</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Hitzl</surname><given-names>Wolfgang</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mayer</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Koller</surname><given-names>Heiko</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>German Scoliosis Center Bad Wildungen, Werner-Wicker-Klinik, Bad Wildungen, Germany.</aff><aff id="A2"><label>2</label>Biostatistics, Research Office, Paracelsus Medical University Salzburg, Salzburg, Austria.</aff><author-notes><corresp>Corresponding author: Juliane Zenner. German Scoliosis Center, Werner-Wicker-Klinik, Im Kreuzfeld 4, 34537 Bad Wildungen, Germany. Tel: +49-1511-6723680, Fax: +49-5621-80320, <email>juliane.zenner@gmx.de</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>13</day><month>2</month><year>2015</year></pub-date><volume>9</volume><issue>1</issue><fpage>39</fpage><lpage>46</lpage><history><date date-type="received"><day>29</day><month>4</month><year>2014</year></date><date date-type="rev-recd"><day>19</day><month>5</month><year>2014</year></date><date date-type="accepted"><day>20</day><month>5</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2015 by Korean Society of Spine Surgery</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Study Design</title><p>This was a prospective randomized comparative study.</p></sec><sec><title>Purpose</title><p>The aim of this study was to objectify donor site-related pain following anterior iliac crest graft harvesting, in patients who have undergone multilevel anterior cervical discectomy and fusion with plating (ACDFP); and to assess the effect of an intraoperative local single injection of ropivacaine on postoperative pain.</p></sec><sec><title>Overview of Literature</title><p>Multilevel ACDFP can be associated with a high non-union rate. Autogenous iliac bone has been used to increase union rates, although a high incidence of donor site-related pain has been reported.</p></sec><sec><title>Methods</title><p>Forty consecutive patients who required 3-level or 4-level ACDFP were prospectively assessed for donor site-related pain. Pain levels were assessed daily for five days postoperative using the visual analog scale (VAS). Patients were randomly assigned to group A or B. In group A patients, 7-10 mL of ropivacaine (0.2%) was injected into the iliac crest after iliac crest graft harvesting. Morphine usage via patient controlled analgesia was calculated. At six months postoperative, patient complaints at the harvest site were documented.</p></sec><sec><title>Results</title><p>Patients were randomly assigned to group A or B. In group A, ropivacaine was locally administered at the site of the iliac crest graft harvest after fascia closure. In group B, no additional treatments were administered. The average patient age in group A was 56±7.6 years, whereas the average age of patients in group B was 52.6±10.4 years. Group A had an average of 0.6±0.7 previous surgeries per patient, whereas group B had an average of 0.8±1.0 previous surgeries per patient. The average number of levels fused in group A was 3.6±0.7, whereas the average number of levels fused in group B was 3.7±0.9 (all <italic>p</italic>>0.05). In group A, the mean ropivacaine volume administered was 8.4±1.5 mL. No patient complaints regarding chronic pain, were reported six months postoperatively. No complications were encountered from the harvest site, and all patients underwent successful 3-level and 4-level ACDFP. Statistical analysis showed significant differences for VAS on postoperative day 1 (<italic>p</italic>=0.004) and day 2 (<italic>p</italic>=0.005).</p></sec><sec><title>Conclusions</title><p>VAS assessment showed overall moderate perioperative morbidity in terms of donor site-related pain, which was reduced by administering ropivacaine.</p></sec></abstract><kwd-group><kwd>Spine</kwd><kwd>Bone grafting</kwd><kwd>Complications</kwd><kwd>Local anesthetics</kwd><kwd>Pain assessment</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" orientation="portrait" position="float"><label>Fig. 1</label><caption><p><bold>(A-I)</bold> Surgical technique for iliac crest graft harvesting. In all cases, bicortical corticocancellous grafts were harvested from the inner iliac tablet approximately 2 cm proximal to the anterior superior iliac spine using an oscillating saw. Subsequently, bone-wax was used to stop bleeding from the cancellous bone, and an absorbable sponge (3×5 cm, Spongostan, Johnson&Johnson, New Brunswick, USA) was inserted into the defect. After refixation of the abdominal fascia to the iliac crest, one surgeon administered 7-10 mL of ropivacaine (0.2%) into the defect, the abdominal fascia and the iliac crest using a cannula (group A). The other patients constituted group B; this group underwent an identical procedure without the administration of ropivacaine.</p></caption><graphic xlink:href="asj-9-39-g001"></graphic></fig><fig id="F2" orientation="portrait" position="float"><label>Fig. 2</label><caption><p>Graph illustrating perioperative changes in pain at the iliac crest graft harvest site. The dashed red line indicates the ropivacaine group, and the blue line indicates the control group. Notably, patients in the ropivacaine group had less pain at all time points postoperative relative to the control group, and significant differences were observed for days 1 and 2 postoperative. VAS, visual analog scale.</p></caption><graphic xlink:href="asj-9-39-g002"></graphic></fig><table-wrap id="T1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Patient characteristics and VAS scores</p></caption><graphic xlink:href="asj-9-39-i001"></graphic><table-wrap-foot><fn><p>Values are presented as mean±standard deviation (minimum-maximum).</p><p>VAS, visual analog scale; NA, not applicable.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Allemagne</li><li>Autriche</li></country></list><tree><country name="Allemagne"><noRegion><name sortKey="Zenner, Juliane" sort="Zenner, Juliane" uniqKey="Zenner J" first="Juliane" last="Zenner">Juliane Zenner</name></noRegion><name sortKey="Koller, Heiko" sort="Koller, Heiko" uniqKey="Koller H" first="Heiko" last="Koller">Heiko Koller</name><name sortKey="Mayer, Michael" sort="Mayer, Michael" uniqKey="Mayer M" first="Michael" last="Mayer">Michael Mayer</name></country><country name="Autriche"><noRegion><name sortKey="Hitzl, Wolfgang" sort="Hitzl, Wolfgang" uniqKey="Hitzl W" first="Wolfgang" last="Hitzl">Wolfgang Hitzl</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Ncbi/Merge
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 005871 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd -nk 005871 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= EdenteV2
|flux= Ncbi
|étape= Merge
|type= RBID
|clé= PMC:4330217
|texte= Analysis of Postoperative Pain at the Anterior Iliac Crest Harvest Site: A Prospective Study of the Intraoperative Local Administration of Ropivacaine
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Merge/RBID.i -Sk "pubmed:25705333" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV2
| This area was generated with Dilib version V0.6.32. |  |