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.

Abstract

Acute Interventional Perioperative Pain Service consultants have routinely placed paravertebral nerve block (PVB) catheters for the continuous release of ropivacaine following stage I microtia reconstruction with costal cartilage graft at our institution since 2010. A retrospective chart review from July 2006 was performed to compare the length of hospital stay, median pain score (0-10 scale), and opioid use of patients receiving PVB with those of historical controls. Statistical analysis included t, Mann-Whitney U, and Fisher's exact tests. A total of 15 stage I microtia surgeries were included, 10 with PVB and 5 without. Patients with and without PVB had high peak pain scores (8.4 vs 7.8), remained in the hospital for 3.5 and 3.8 days, and consumed 0.69 and 0.36 mg/kg morphine equivalents, respectively. These findings highlight the feasibility of PVB, but larger studies are needed to optimize pain relief in this population.

Keywords: costochondral graft; microtia; paravertebral block; rib cartilage graft; surgical pain; ultrasound.

MeSH terms

  • Adolescent
  • Amides / administration & dosage*
  • Anesthesia, Spinal / methods*
  • Anesthetics, Local / administration & dosage*
  • Cartilage / transplantation*
  • Child
  • Child, Preschool
  • Congenital Microtia / surgery*
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Nerve Block / methods*
  • Pain Management / methods*
  • Pain Measurement
  • Pilot Projects
  • Plastic Surgery Procedures*
  • Retrospective Studies
  • Ropivacaine

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine