Costal Cartilage Donor-site Pain: Does Abdominal Muscle Infiltration Analgesia Work?

Xiaohui Su60 enrolled

Overview

Donor-site pain is an adverse effect of autologous ear reconstruction. A well-planned pain management protocol is needed. The objective of this study was to introduce rectus abdominis and external oblique muscle infiltration analgesia (RAM+EOM-IA) in autologous ear reconstruction and to evaluate its efficacy and safety.

Patients were included in two cohorts: intermittent RAM+EOM-IA combined with intravenous patient-controlled anesthesia (IPCA) and IPCA alone. The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively. Secondary outcomes included the Barthel index and rescue analgesic consumption. Additionally, areas of sensory block were tested using a cold stimulus.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Rectus Abdominis and External Oblique Muscle Infiltration Analgesia

Interventions

rectus abdominis(RAM) and external oblique muscle(EOM) infiltration analgesiaPROCEDURE

After suturing the muscular fascia, an indwelling catheter was placed above the RAM and EOM and under the subcutaneous tissue and then sutured to the skin for fixation. Approximately 30 min before surgery completion, 1 mg/kg of 0.2% ropivacaine was infused through the indwelling catheter for IA. Additionally, 1 mg/kg of 0.2% ropivacaine was infused through the indwelling catheter every 12 h, starting 8 h postoperatively, injected four times.

intravenous patient-controlled anesthesiaPROCEDURE

After completion of the operation, the anesthesiologist used the IPCA device; it was programmed with a background infusion rate of 2 mL/h, a bolus volume of 2 mL, and a lockout interval of 15 minutes. The 100 mL total volume of the PCA consisted of normal saline, 2.0 ug/kg sufentanil, and adjuvant antiemetic (tropisetron).

Eligibility

Sex: ALLMin age: 8 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All patients were microtia and underwent the first stage of autologous ear reconstruction by the same experienced surgeon in First Affiliated Hospital of Fujian Medical University. Exclusion Criteria: * Patients were excluded if they over 18 years old; discontinued analgesic therapy; regularly used opioids, other analgesics, sedative medications, or corticosteroids; were unable to express pain scores due to comorbidities such as mental retardation; or had incomplete data.

Locations (1)

The First Affiliated Hospital of Fujian Medical University

Fuzhou, Fujian, China

Outcomes

Primary Outcomes

numeric rating scale

The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively

Time frame: 4,8,12,16,20,24,28,32,36,40,44,48hours after surgery

Rescue analgesics consumption

Rescue analgesics were administered only on demand and not routinely. During the postoperative days, physicians prescribed 15 mg/kg oral acetaminophen if the pain was unbearable.

Time frame: 48hours after surgery

Secondary Outcomes

Barthel's index

The Barthel's index measures the ability to perform daily activities after surgery

Time frame: 24hours after surgery

Data from ClinicalTrials.gov

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