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Donor-site pain is an adverse effect of autologous ear reconstruction. A well-planned pain management protocol is needed. The objective of this study was to introduce rectus abdominis and external oblique muscle infiltration analgesia (RAM+EOM-IA) in autologous ear reconstruction and to evaluate its efficacy and safety.
Patients were included in two cohorts: intermittent RAM+EOM-IA combined with intravenous patient-controlled anesthesia (IPCA) and IPCA alone. The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively. Secondary outcomes included the Barthel index and rescue analgesic consumption. Additionally, areas of sensory block were tested using a cold stimulus.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group-PCIA | Placebo Comparator |
| |
| Group-IA+PCIA | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| rectus abdominis(RAM) and external oblique muscle(EOM) infiltration analgesia | Procedure | After suturing the muscular fascia, an indwelling catheter was placed above the RAM and EOM and under the subcutaneous tissue and then sutured to the skin for fixation. Approximately 30 min before surgery completion, 1 mg/kg of 0.2% ropivacaine was infused through the indwelling catheter for IA. Additionally, 1 mg/kg of 0.2% ropivacaine was infused through the indwelling catheter every 12 h, starting 8 h postoperatively, injected four times. |
| Measure | Description | Time Frame |
|---|---|---|
| numeric rating scale | The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively | 4,8,12,16,20,24,28,32,36,40,44,48hours after surgery |
| Rescue analgesics consumption | Rescue analgesics were administered only on demand and not routinely. During the postoperative days, physicians prescribed 15 mg/kg oral acetaminophen if the pain was unbearable. | 48hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Barthel's index | The Barthel's index measures the ability to perform daily activities after surgery | 24hours after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Fujian Medical University | Fuzhou | Fujian | 350000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27350268 | Background | Niiyama Y, Yotsuyanagi T, Yamakage M. Continuous wound infiltration with 0.2% ropivacaine versus a single intercostal nerve block with 0.75% ropivacaine for postoperative pain management after reconstructive surgery for microtia. J Plast Reconstr Aesthet Surg. 2016 Oct;69(10):1445-9. doi: 10.1016/j.bjps.2016.05.009. Epub 2016 Jun 2. | |
| 27430605 |
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| intravenous patient-controlled anesthesia | Procedure | After completion of the operation, the anesthesiologist used the IPCA device; it was programmed with a background infusion rate of 2 mL/h, a bolus volume of 2 mL, and a lockout interval of 15 minutes. The 100 mL total volume of the PCA consisted of normal saline, 2.0 ug/kg sufentanil, and adjuvant antiemetic (tropisetron). |
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| Woo KJ, Kang BY, Min JJ, Park JW, Kim A, Oh KS. Postoperative pain control by preventive intercostal nerve block under direct vision followed by catheter-based infusion of local analgesics in rib cartilage harvest for auricular reconstruction in children with microtia: A randomized controlled trial. J Plast Reconstr Aesthet Surg. 2016 Sep;69(9):1203-10. doi: 10.1016/j.bjps.2016.06.026. Epub 2016 Jul 9. |
| 26908556 | Background | Shaffer AD, Jabbour N, Visoiu M, Yang CI, Yellon RF. Paravertebral Nerve Block for Donor Site Pain in Stage I Microtia Reconstruction: A Pilot Study. Otolaryngol Head Neck Surg. 2016 May;154(5):898-901. doi: 10.1177/0194599816629395. Epub 2016 Feb 23. |
| 39342766 | Derived | Wei S, Ye J, Lei C, Huang Q, Lin B, Su X, Zheng H, Shan X, Wang B, Wang M. Abdominal muscles infiltration analgesia for donor-site pain in autologous ear reconstruction: A randomized controlled clinical trial. J Plast Reconstr Aesthet Surg. 2024 Dec;99:38-46. doi: 10.1016/j.bjps.2024.09.019. Epub 2024 Sep 20. |