Reduction in late postoperative pain after iliac crest bonegraft harvesting for cervical fusion: a controlled double-blinded study of 100 patients

Schaan, M.; Schmitt, N.; Boszczyk, Bronek M.; Jaksche, H.

doi:10.1007/s00701-004-0328-y

Cited by 13 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the size of graft varied depending on the main surgical site. However, according to Schaan et al, 22 there is no correlation between pain scores and the size of graft harvested. We could not evaluate analgesic consumption at 18 months in connection with the iliac crest pain.…”

Section: Discussionmentioning

confidence: 99%

The Ultrasound-Guided Transversus Abdominis Plane Block for Anterior Iliac Crest Bone Graft Postoperative Pain Relief

Chiono¹,

Bernard²,

Bringuier³

et al. 2010

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

The Ultrasound-Guided Transversus Abdominis Plane Block for Anterior Iliac Crest Bone Graft Postoperative Pain Relief

Chiono¹,

Bernard²,

Bringuier³

et al. 2010

Regional Anesthesia and Pain Medicine

View full text Add to dashboard Cite

show abstract

“…This procedure is associated with significant and prolonged postoperative pain. Some studies confirm the benefit of placing a wound catheter [49–51]. In these, continuous infusion around the donor site significantly improves acute graft‐related pain, hastening recovery and improving patient satisfaction, and has been associated with no complications.…”

Section: Surgical Applicationsmentioning

confidence: 95%

Wound infiltration for surgery

Scott

2010

Anaesthesia

115

View full text Add to dashboard Cite

SummaryWound infiltration with local anaesthetics is a simple, effective and inexpensive means of providing good analgesia for a variety of surgical procedures without any major side-effects. In particular, local anaesthetic toxicity, wound infection and healing do not appear to be major considerations. The purpose of this review is to outline the existing literature on a procedure-specific basis and to encourage a more widespread acceptance of the technique, ensuring that all layers are infiltrated in a controlled and meticulous manner. A thorough understanding of the pathophysiology of the surgical wound is necessary to improve both analgesia and postoperative recovery for any given operation. Crile's concept of anoci-association almost a century ago has been largely ignored by our specialty. Crile proposed that true peripheral afferent blockade prevents propagation of abnormal reflexes that cause major organ dysfunction and death [1]. Thus, postoperative complications can be minimised and recovery enhanced. Since Crile's original hypothesis, we have learnt that the major reasons for surgical morbidity and mortality are the operation itself, the surgeon's personal expertise, the stress response to that trauma and patient comorbidities.Postoperative analgesia is a major component of perioperative care and local anaesthetic (LA) techniques are more effective than systemic analgesia regardless of the operation and mode of delivery [2]. Until recently, research and clinical practice has focused on central neuraxial blockade and peripheral nerve blockade. These, although highly effective, are reserved for major thoracic and abdominal surgery, mainly because of high failure rates [3] and the risks of infection and spinal haematoma. When choosing a 'procedure-specific' technique, the simplest, safest and most effective block should be employed whenever possible [4]. Thus, the meticulous direct application of LA to each identifiable layer during a surgical procedure has considerable appeal for both surgeon and anaesthetist. Local anaesthetic infiltration for surgery itself has largely been confined to small superficial outpatient procedures. However, performed well, this is a logical means of preventing pain and other noxious stimuli from reaching the spinal cord. When combined with specific nerve blockade, e.g. ilio-inguinal nerve block or transversus abdominis plane (TAP) block during hernia repair, this allows a 'multimodal local anaesthetic' means of combating pain and anoci-association.By allowing patients to mobilise more quickly, wound infiltration may be as effective as central and proximal peripheral blocks in ensuring a safe postoperative recovery. Although untreated postsurgical pain may cause chronic pain [5], our knowledge of its pathogenesis, prevention and treatment is still basic. An individual patient's personality and pain response are important and may correlate to early postoperative pain appreciation and outcome. During surgery, multimodal analgesia combats peripheral and central 'wind-up' and sho...

show abstract

“…Thus, no control group. Total follow-up of 3 months post-op Saber 2009 Follow-up only 2 months Salengros 2010 RCT investigating pre- vs postoperative epidural anaesthesia after thoracotomy Schaan 2004 Pain outcomes measured < 3 months Schley 2007 Study on effect of adjuvants for LAs to prevent chronic postsurgical pain. All 19 participants received a continuous brachial plexus block for 1 week after the amputation of an upper extremity.…”

Section: Appendicesmentioning

confidence: 99%

Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children

Weinstein

Levene

Cohen

et al. 2018

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

We conclude that there is moderate-quality evidence that regional anaesthesia may reduce the risk of developing PPP after three to 18 months after thoracotomy and three to 12 months after caesarean section. There is low-quality evidence that regional anaesthesia may reduce the risk of developing PPP three to 12 months after breast cancer surgery. There is moderate evidence that intravenous infusion of local anaesthetics may reduce the risk of developing PPP three to six months after breast cancer surgery.Our conclusions are considerably weakened by the small size and number of studies, by performance bias, null bias, attrition and missing data. Larger, high-quality studies, including children, are needed. We caution that except for breast surgery, our evidence synthesis is based on only a few small studies. On a cautionary note, we cannot extend our conclusions to other surgical interventions or regional anaesthesia techniques, for example we cannot conclude that paravertebral block reduces the risk of PPP after thoracotomy. There are seven ongoing studies and 12 studies awaiting classification that may change the conclusions of the current review once they are published and incorporated.

show abstract

Reduction in late postoperative pain after iliac crest bonegraft harvesting for cervical fusion: a controlled double-blinded study of 100 patients

Abstract: This data shows that intra-operative blockage of peripheral nociceptive structures results in decreased pain at later time points. We conclude that wound infiltration with 7,5% Ropivacaine after bonegraft removal at the iliac crest is effective in reducing postoperative pain.

Cited by 13 publications

References 12 publications

The Ultrasound-Guided Transversus Abdominis Plane Block for Anterior Iliac Crest Bone Graft Postoperative Pain Relief

The Ultrasound-Guided Transversus Abdominis Plane Block for Anterior Iliac Crest Bone Graft Postoperative Pain Relief

Wound infiltration for surgery

Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children

Contact Info

Product

Resources

About