title: Evaluation of the efficacy of bupivacaine soaked in Gelfoam(®) at the iliac crest bone graft site.
abstract: OBJECTIVE
  A substantial number of patients report pain after graft harvest from the anterior iliac crest. This study examined the efficacy of local application of bupivacaine soaked in a Gelfoam(®) at the bone donor site in controlling postoperative pain and parenteral opioid use.
  
  
  METHODS
  We performed a prospective, double-blind, randomized, placebo-controlled study comparing intraoperative infiltration of 20 mililiters of bupivacaine (treatment, group B) versus saline (placebo), with Gelfoam(®) soaked into the iliac crest harvest site for patients undergoing elective cervical spinal surgery. Postoperative administration of dihydromorphinone hydrochloride (post anesthesia care unit and patient-controlled analgesia) was standardized. A pain score based on a 10-point visual analog scale (VAS). was used to assess the severity of pain associated with donor site. Pain scores and narcotic use/frequency were recorded at the twenty-four and forty-eighth hour after the operation. Physicians, patients, nursing staff, and statisticians were blinded to the treatment.
  
  
  RESULTS
  The groups were similar in baseline age, gender, and comorbidities. There was no significant difference between groups in VAS scores. Narcotic dosage, were significantly less in the Group B at 24 and 48 hours (p<0.05).
  
  
  CONCLUSIONS
  This study has demonstrated that bupivacaine soaked in gelfoam at the iliac bone graft harvest site reduced postoperative parenteral opioid usage.
authors.affiliation: Ankara Numune Training and Research Hospital, Anesthesiology and Reanimation Department, Ankara, Turkey. mgamli@mynet.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gamli
authors.forename: Ali
authors.initials: A
authors.lastname: Dalgic
authors.forename: Dilsen
authors.initials: D
authors.lastname: Ornek
authors.forename: Eyüp
authors.initials: E
authors.lastname: Horasanli
authors.forename: Oya
authors.initials: O
authors.lastname: Kilci
authors.forename: Canan
authors.initials: C
authors.lastname: Un
authors.forename: Bayazit
authors.initials: B
authors.lastname: Dikmen
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000494:pharmacology; D004311:Double-Blind Method; D016503:Drug Delivery Systems; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006490:Hemostatics; D006801:Humans; D007085:Ilium / Q000187:drug effects* / Q000637:transplantation*; D008297:Male; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D006490:Hemostatics; D002045:Bupivacaine