Perioperative Outcome Differences between Pain Management Protocols in Cleft Alveolar Bone Grafting

Viren Patel, Robin Yang, Kaitlyn M. Paine, David W. Low, Jesse A. Taylor, Oksana A. Jackson

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose:Postoperative hip pain is commonly reported after anterior iliac crest harvest for alveolar bone grafting. The goal of this study is to describe our institution's experience and examine the efficacy of our pain management protocols.Methods:A retrospective review was performed by abstracting demographic, operative, and pain management data from January 2011 to April 2013. Paired t-tests and Fisher exact tests were used to examine differences when comparing 2 groups, while ANOVA was used to examine difference between the 3 protocols for harvest and pain management: Trapdoor technique and local anesthetic injection (TD+LAI), TD and pain catheter (TD+PC), and split crest and LAI.Results:Eighty-four patients, 52 males (61.9%), averaging 8.8 years old (±2.9) were included. Postoperatively, 17 (71%) patients in the PC group received IV narcotics compared to 27 (45%) in those without a PC (P = .03). When comparing all 3 protocols, no significant difference was found in IV morphine usage or duration of IV morphine treatment. In subgroup analysis, when patients in the groups TD+PC versus TD+LAI were examined, those in the TD+PC group had significantly shorter hospital stays and were more likely to go home postoperative day 1 (P = .03; P = .04).Conclusions:Overall, patients tolerated alveolar bone grafting well regardless of harvest technique or pain management approach. While indwelling PCs did not significantly decrease IV morphine usage, these patients had significantly shorter lengths of stays.

Original languageEnglish (US)
Pages (from-to)230-233
Number of pages4
JournalJournal of Craniofacial Surgery
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2020
Externally publishedYes

Keywords

  • Alveolar cleft
  • bone graft
  • cleft alveolar
  • pain control

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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