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

Head Neck. 2021 Apr;43(4):1063-1072. doi: 10.1002/hed.26562. Epub 2021 Feb 23.

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.

Keywords: fibula free flap; local analgesia; osteocutaneous free flap; postoperative pain; ropivacaine; scapula free flap.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Double-Blind Method
  • Fibula
  • Free Tissue Flaps*
  • Humans
  • Pain
  • Pain Management
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Ropivacaine

Substances

  • Ropivacaine

Associated data

  • ClinicalTrials.gov/NCT03349034