The efficacy of local anaesthetic for pain after iliac bone harvesting: A randomised controlled trial

Introduction: Autogenous bone grafting is commonly used in reconstructive surgery but postoperative pain from the donor site can be severe, delaying early mobilisation and preventing discharge from hospital. Method: An RCT of levobupivacaine infusion (16.25 mg/h for 24 h) of iliac crest wounds versus placebo. Postoperative pain was recorded immediately on returning to the ward, then at 1, 2, 3, 4, 5, 6 h, morning and evening on subsequent days until discharge, and at the 7-day clinic appointment. Mobility was recorded twice daily and at 7 days. Results: Of 46 evaluable patients, 25 were randomised to levobupivacaine and 21 to placebo. Mean pain scores for (i) average pain from initial assessment to 6 h; (ii) 1 day in the morning; (iii) 1 day in the evening; (iv) at 2 days; and (v) follow-up were all statistically significant in favour of lower pain scores in the levobupivicaine group (p-values all