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The main limitation to this study was the small sample size, which resulted from a dramatic decrease in elective surgery being performed at this hospital. Power calculations undertaken prior to commencement of the study showed that a sample of 50 participants was needed to detect an overall significant difference between the two groups. Although statistical significance was not achieved for all variables, it can be argued that this study's findings were clinically significant; the study group experienced better donor site pain management than the placebo group. A larger study is therefore recommended to provide conclusive scientific evidence for the use of bupivacaine in pain management of patients undergoing bone harvesting.
Summary
This study, despite the small sample size, found the use of bupivacaine 0.25% reduced iliac crest donor site pain in patients undergoing single-level ACE Encouraging results were identified for younger participants receiving the study drug (<49 years)--they required less morphine and had a reduced length of stay. Furthermore, the use of this low-dose local anesthetic was found to reduce IV morphine usage overall and also facilitated a reduction in donor site pain on ambulation.
Acknowledgments
The authors thank Shane Van Leeuwen, senior pharmacist, for undertaking the randomization of participants and the organization of the study and placebo treatments; the anesthetists who provided assistance with data collection; nursing staff members on the neurosurgical ward for assisting in data collection; and Janice Low for administrative support.
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RELATED ARTICLE: What speaks to you.
AANN is conducting a survey to find out what kind of information you need in your practice of neuroscience nursing and how AANN can best deliver it to you. Please take a few minutes to respond to the survey questions found online at www.aann.org. The survey is in the Members Only section of the Web site. See the mail panel of this issue of JNN for your membership ID number, which you will need to log on to Members Only. Thank you in advance for sharing your thoughts with AANN.
Questions or comments about this article may be directed to: Jeanne Young, RN BSc (Hons), SCGH Department of Nursing Research and Development, Q Block Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, 6009 Australia, e-mail jeanne.young@health.wa.gov.au. She is a clinical nurse consultant: research and has worked in nursing research for 5 years.
Naree Cowan, RN B Nsg, is a senior clinical nurse at Sir Charles Gairdner Hospital and has worked in the area of neurosciences for 11 years.
Dermot Murphy, MD MBBCh BA OFFARCSI, is a senior anesthetist at Sir Charles Gairdner Hospital and specializes in the area of neurosurgery.
Cassi Bladen, BSc (Physio), is a senior physiotherapist at Sir Charles Gairdner Hospital, specializing in neurosciences, and is associated with the Australian Neuromuscular Institute's research into stroke rehabilitation.
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