The Effect of Single‑Dose Bupivacaine on Postoperative Iliac Crest Graft Donor Site Pain

Abstract

Background: Postoperative donor site pain remains a major source of morbidity following iliac crest bone graft harvesting (ICBGH). Aim: The aim of this study was to investigate the effect of single-dose infiltration of bupivacaine on donor site pain following ICBGH. Subjects and Methods: This study was a double-blind randomized controlled trial of 30 adult individuals that required an ICBG as part of the treatment for mandibular reconstruction. Individuals were divided into two groups, to receive a single-dose subcutaneous infiltration of either 0.25% bupivacaine or 0.9% normal saline at the iliac crest graft incision site following ICBGH. Length of incision at the ICBGH site, dimensions of harvested graft, time taken for the iliac crest harvest surgery, total daily dose of postoperative analgesics, pain from the ICBGH site as well as gait disturbance were recorded. Data were analyzed using SPSS version 17.0, and P < 0.05 was considered statistically significant. Results: There was a progressive decrease in pain score from the 1^st to the 4^th postoperative day, with no significant difference between the two groups. There was no statistical difference between the two groups in terms of dynamic median pain score at the early postoperative period as well as at the 4^th and 12^th week postoperative period. The analgesic consumption between the two groups also did not show any significant difference. Conclusion: Local injection of single dose of 0.25% bupivacaine did not offer additional benefit in the management of postoperative iliac crest donor site pain following ICBGH.