Bupivacaine hydrochloride-soaked dressings versus subcutaneous infiltration for postoperative analgesia in skin graft donor sites.

Abstract

Skin grafting is associated with postoperative pain. Bupivacaine hydrochloride, a local anesthetic, has been studied for its effectiveness in providing analgesia for donor sites following skin grafting. This study aimed to compare the efficacy of bupivacaine hydrochloride-soaked dressings with subcutaneous infiltration for managing postoperative donor site pain in patients undergoing skin grafting procedures. This randomized, controlled, double-blinded prospective study included 90 patients. The study participants were divided into three equal groups: Group A (bupivacaine-soaked dressing), Group B (subcutaneous infiltration), and Group C (control received conventional dressing without any adjuvants). Pain scores, ketorolac analgesia, and fentanyl requirements were recorded. Both Group A and Group B exhibited significantly lower postoperative pain scores compared to Group C (p < 0.01). The time to first analgesic request was significantly prolonged in Groups A and B relative to Group C (p < 0.0001). Furthermore, the frequency of analgesic use was markedly reduced: 80.0 % of patients in Group A and 66.7 % in Group B required ketorolac only 1-2 times, whereas 96.7 % of patients in Group C required it more than twice (p < 0.0001). Fentanyl supplementation was rarely needed in Group A (0 %) and infrequent in Group B (6.7 %), compared to 46.7 % in Group C (p < 0.0001). The application of bupivacaine hydrochloride, whether administered via soaked dressings or local infiltration, demonstrates a significant postoperative analgesic effect. Applying bupivacaine-soaked dressing is recommended for ease of use and lack of requirement for specialized equipment or preparation.