Local infusion of ropivacaine for pain control after osseous free flaps: Randomized controlled trial

Scott Roof, Rocco Ferrandino, Caroline Eden, Yury Khelemsky, Marita Teng, Eric Genden, Samuel DeMaria, Brett A. Miles

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Donor site pain after osteocutaneous free flap surgery contributes to postoperative morbidity and impairs recovery. We evaluated the efficacy of local infusion of ropivacaine for treating donor-site pain after surgery. Methods: We conducted a randomized, double-blind, placebo-controlled trial of patients undergoing osteocutaneous fibula or scapular tip free flaps for head and neck reconstruction at Mount Sinai Hospital. Patients were randomized to receive local infusion of ropivacaine or saline. We compared Visual Analog Scale pain scores for donor-site specific pain 48 hours after surgery. Results: There were 8 fibular free flap and 10 scapular free flap reconstructions. Average donor-site pain scores were 29 ± 22 and 31 ± 28 mm (P =.88) for placebo and ropivacaine arms, respectively. The trial was stopped after the planned interim analysis for futility of the intervention. Conclusions: Local infusion of ropivacaine did not affect donor-site specific pain scores in this population. ClinicalTrials.gov Identifier: NCT03349034.

Original languageEnglish
Pages (from-to)1063-1072
Number of pages10
JournalHead and Neck
Volume43
Issue number4
DOIs
StatePublished - Apr 2021

Keywords

  • fibula free flap
  • local analgesia
  • osteocutaneous free flap
  • postoperative pain
  • ropivacaine
  • scapula free flap

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