Paediatric Anaesthesia and Intensive Care
Pain control after iliac crest bone graft surgery in children: intravenous ketorolac vs. continuous bupivacaine infusion
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:
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.
1 Blumenthal S et al. Anesthesiology 2005; 102: 392-7.
© 2007 European Society of Anaesthesiology
2 Puri R et al. Am J Orthop 2000; 29: 443-6.