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Paediatric Anaesthesia and Intensive Care

Pain control after iliac crest bone graft surgery in children: intravenous ketorolac vs. continuous bupivacaine infusion

10AP6-4

Espinal, V; Hayes, J.; Bissonnette, B.

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European Journal of Anaesthesiology (EJA): June 2007 - Volume 24 - Issue - p 137-138
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Background and Goal of Study: Iliac Crest Bone Graft surgery (ICBG) is painful. Postoperative pain management includes the infusion of local anesthetics into the wound via an indwelling catheter (1,2) and/or non steroidal anti-inflammatory drugs (NSAIDs). The purpose of this study is to compare the efficacy of intravenous ketorolac to local bupivacaine infusion for pain control after ICBG.

Materials and Methods: To date, four patients older than 10 years requiring ICBG for alveolar cleft repair or Lefort I osteotomy have been studied. Patients were randomly assigned in a blinded fashion to receive either: IV ketorolac 0.5 mg/kg q8h (Group K); IV ketorolac and local infusion of plain bupivacaine 0.25% at 0.1 ml/kg/hour for 48 hours (Group K + B); or bupivacaine infusion alone (Group B). All patients received PCA morphine and oral acetaminophen.

Results and Discussions:

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Conclusion: The patient who received bupivacaine infusion alone had the highest average pain score and cumulative morphine consumption over 48 hours when compared to the patients who received ketorolac + / − bupivacaine infusion.

References:

1 Blumenthal S et al. Anesthesiology 2005; 102: 392-7.
2 Puri R et al. Am J Orthop 2000; 29: 443-6.
© 2007 European Society of Anaesthesiology