Systematic literature review of topical local anaesthesia or analgesia to donor site wounds

Craig A McBride; Marilyn Wong; Bhaveshkumar Patel

doi:10.1093/burnst/tkac020

您当前的位置：

首页 >

文章列表页 >

Systematic literature review of topical local anaesthesia or analgesia to donor site wounds

更新时间：2023-09-05

- Systematic literature review of topical local anaesthesia or analgesia to donor site wounds
- Burns & Trauma Vol. 10, Issue 1, (2022)
- 作者机构：
  
  1. Pegg Leditschke Children’s Burns Centre, Queensland Children’s Hospital
  2. Centre for Children’s Burns and Trauma Research
  3. University of Queensland
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkac020
  CLC：
- Published：2022，
  
  Published Online：19 September 2022，
扫描看全文
Craig A McBride, Marilyn Wong, Bhaveshkumar Patel, Systematic literature review of topical local anaesthesia or analgesia to donor site wounds, Burns & Trauma, Volume 10, 2022, tkac020, https://doi.org/10.1093/burnst/tkac020
DOI：

Craig A McBride, Marilyn Wong, Bhaveshkumar Patel, Systematic literature review of topical local anaesthesia or analgesia to donor site wounds, Burns & Trauma, Volume 10, 2022, tkac020, https://doi.org/10.1093/burnst/tkac020 DOI：

摘要

Abstract

BackgroundTopical local analgesic and anaesthetic agents have been used both pre- and immediately post-harvest on split-thickness skin graft (STSG) donor site wounds (DSW). There is no systematic review of their effectiveness in providing post-harvest analgesia

or of the possible toxic effects of systemic absorption. This study is designed to address the question of which agent

if any

is favoured over the others and whether there are any safety data regarding their use.MethodsSystematic literature review of randomised controlled trials of topical agents applied to STSG DSWs

with a view to providing analgesia. Studies identified via search of Cochrane and EBSCO databases. No restrictions on language or publication year. Primary outcomes: pain at the time of (awake) STSG

and post-harvest pain (up to first dressing change). Secondary outcome was serum medication levels relative to published data on toxic doses. Cochrane risk of bias assessment tool utilised in assessment of included studies. At least 2 reviewers screened and reviewed included studies. A narrative review is presented.ResultsThere were 11 studies meeting inclusion criteria. Overall methodological quality and patient numbers were low. Topical eutectic mixture of lidocaine and prilocaine pre-harvest affords good local anaesthesia in awake STSG harvesting. Topical bupivacaine (5 studies) or lidocaine (1 study) gave significantly better post-harvest anaesthesia/analgesia than placebo. Topical morphine performs no better than placebo. Topical local anaesthetic agents at reported doses were all well below toxic serum levels.ConclusionsTopical local anaesthetics (lidocaine or bupivacaine) provide good analgesia

both during and after STSG harvest

at well below toxic serum levels

but there are no good data determining the best local anaesthetic agent to use. There is no evidence morphine performs better than placebo.

关键词

Keywords

Local anaestheticDonor site woundTopical analgesiaLidocaineBupivacaineMorphinesplit-thickness skin graftEMLA

references

1.Birchall MA, Varma S, Milward TM. The Moriarty sign: an appraisal. Br J Plast Surg. 1991;44:149–50.

2.Stark RB. Plastic Surgery. Hoeber Medical Division. New York:Harper and Row, 1962.

3.Taylor A, McLeod G. Basic pharmacology of local anaesthetics. Bja Educ. 2019;20:34–41.

4.Cassuto J, Sinclair R, Bonderovic M. Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand. 2006;50:265–82.

5.Cruz FF, Rocco PRM, Pelosi P. Anti-inflammatory properties of anesthetic agents. Crit Care. 2017;21:67.

6.Drucker M, Cardenas E, Arizti P, Valenzuela A, Gamboa A. Experimental Studies on the Effect of Lidocaine on Wound Healing. World J Surg. 1998;22:394–8.

7.Waite A, Gilliver SC, Masterson GR, Hardman MJ, Ashcroft GS. Clinically relevant doses of lidocaine and bupivacaine do not impair cutaneous wound healing in mice. Br J Anaesth. 2010;104:768–73.

8.Minto BW, Zanato L, Franco GG, Kawamoto FYK, Borsaro CP, Pazzini JM, et al. Topical application of lidocaine or bupivacaine in the healing of surgical wounds in dogs. Acta Cir Bras. 2020;35:e202000701.

9.Berthézène CD, Rabiller L, Jourdan G, Cousin B, Pénicaud L, Casteilla L, et al. Tissue Regeneration: The Dark Side of Opioids. Int J Mol Sci. 2021;22:7336.

10.Stein C, Lang LJ. Peripheral mechanisms of opioid analgesia. Curr Opin Pharmacol. 2009;9:3–8.

11.Baker KS, Furnas DW. Cutting Skin Grafts: Using Modified Frost Anesthesia Device. Arch Surg. 1969;98:245–6.

12.Wilson JW, Luikart R, Ayres S. Dichlorotetrafluoroethane for surgical skin planing: A Safe Anesthetic-Refrigerant. AMA Arch Derm. 1955;71:523–3.

13.Furnas DW. Freon 114: better anesthetic for taking split-thickness skin grafts. Plast Reconstr Surg. 1990;86:382.

14.Wilson JW, Ayres S, Luikart R. Mixtures of fluorinated hydrocarbons as refrigerant anesthetic: A Hazard in Use in Surgical Skin Planing. AMA Arch Derm. 1956;74:310–1.

15.Ayres S, Wilson JW, Luikart R. Recent developments in surgical skin planing. Calif Med. 1958;88:127–32.

16.Spadafora A, Zancolli EA. Small skin grafts taken with local ethyl chloride anesthesia. Prensa Med Argent. 1953;40:112–3.

17.Gibraiel EA. A simple bed-side skin grafting procedure. Brit J Plast Surg. 1971;24:238–40.

18.Munoz-Gray A. Ethyl chloride for grafting the conscious patient. Brit J Plast Surg. 1969;22:183–4.

19.Sarig A. Simple, rapid, and painless method for taking split-thickness skin grafts using ethyl chloride spray. Plast Reconstr Surg. 1989;84:541.

20.Melmed EP. Skin grafting using ethyl chloride. S Afr Med J. 1972;46:1603–6.

21.Lowe JP. Skin grafting using ethyl chloride. Proc Mine Med Off Assoc SA. 1974;53:89.

22.McBride CA, Patel B, Kimble RM, Stockton KA. Surgeon’s practices and beliefs in Australia and New Zealand regarding the donor site wound for paediatric skin grafts. J Paediatr Child Health. 2021;57:58–63.

23.Munson ES, Martucci RW, Wagman IH. Bupivacaine and lignocaine induced seizures in rhesus monkeys. Br J Anaesth. 1972;44:1025–9.

24.Berde CB. Convulsions associated with pediatric regional anesthesia. Anesthesia Analgesia. 1992;75:164–6.

25.Butler PE, Eadie PA, Lawlor D, Edwards G, McHugh M. Bupivacaine and Kaltostat reduces post-operative donor site pain. Br J Plast Surg. 1993;46:523–4.

26.Fischer CG, Lloyd S, Kopcha R, Warden GD, McCall JE. The safety of adding bupivacaine to the subcutaneous infiltration solution used for donor site harvest. J Burn Care Rehabil. 2003;24:361–4.

27.Bulmer JN, Duckett AC. Absorption of lignocaine through split-skin donor sites. Anaesthesia. 1985;40:808–9.

28.Read JM, Bach PH. Sterile topical lignocaine jelly in plastic surgery: an assessment of its systemic toxicity. S Afr Med J. 1980;57:704–6.

29.Ohlsén L, Englesson S, Evers H. An anaesthetic Lidocaine/Prilocaine Cream (EMLA) for epicutaneous application tested for cutting split skin grafts. Scand J Plast Recon. 2009;19:201–9.

30.Alvi R, Jones S, Burrows D, Collins W, McKiernan EP, Jones RP, et al. The safety of topical anaesthetic and analgesic agents in a gel when used to provide pain relief at split skin donor sites. Burns. 1998;24:54–7.

31.Higgins JP, Altman DG, Sterne JA. Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 510 (updated March 2011) [Internet]. Chichester (UK):The Cochrane Collaboration; 2011 [cited 2018 Mar 14]. Available from: handbook.cochrane.org

32.Raza MS, Nazim T, Khan FA. Comparison of bupivacaine moistened dressing and conventional dressing for pain relief on skin graft donor sites. J Coll Physicians Surg Pak. 2014;24:416–9.

33.Jenwitheesuk K, Chuangsuwanich A, Areewatana S. Bupivacaine moistened dressing for pain relief on skin graft donor sites. Thai J Surg. 2002;3:83–6.

34.Jellish WS, Gamelli RL, Furry PA, McGill VL, Fluder EM. Effect of topical local anesthetic application to skin harvest sites for pain management in burn patients undergoing skin-grafting procedures. Ann Surg. 1999;229:115–20.

35.Morris WT, Lamb AM. Painless split skin donor sites: a controlled double-blind trial of Opsite, scarlet red and bupivacaine. ANZ J Surg. 1990;60:617–20.

36.Lahteenmaki T, Lillieborg S, Ohlsen L, Olenius M, Strombeck JO. Topical analgesia for the cutting of split-skin grafts: a multicenter comparison of two doses of a lidocaine/prilocaine cream. Plast Reconstr Surg. 1988;82:458–62.

37.Goodacre TEE, Sanders R, Watts DA, Stoker M. Split skin grafting using topical local anaesthesia (EMLA): a comparison with infiltrated anaesthesia. Brit J Plast Surg. 1988;41:533–8.

38.Fransén J, Bastami S, Sjöberg F, Uppugunduri S, Huss FRM. Evaluating topical opioid gel on donor site pain: A small randomised double blind controlled trial. Int J Surg Open. 2016;4:5–9.

39.Zaslansky R, Ben-Nun O, Ben-Shitrit S, Ullmann Y, Kopf A, Stein C. A randomized, controlled, clinical pilot study assessing the analgesic effect of morphine applied topically onto split-thickness skin wounds. J Pharm Pharmacol. 2014;66:1559–66.

40.Desai C, Wood FM, Schug SA, Parsons RW, Fridlender C, Sunderland VB. Effectiveness of a topical local anaesthetic spray as analgesia for dressing changes: a double-blinded randomised pilot trial comparing an emulsion with an aqueous lidocaine formulation. Burns. 2014;40:106–12.

41.Tran AN, Koo JY. Risk of systemic toxicity with topical lidocaine/prilocaine: a review. J Drugs Dermatol. 2014;13:1118–22.

42.Tahir A, Webb JB, Allen G, Nancarrow JD. The effect of local anaesthetic cream (EMLA®) applied with an occlusive dressing on skin thickness. Does it matter? J Plast Reconstr Aesthet Surg. 2006;59:404–8.

43.McBride CA, Kimble RM, Stockton KA. Prospective randomised controlled trial of Algisite™ M, Cuticerin™, and Sorbact® as donor site dressings in paediatric split-thickness skin grafts. Burns Trauma. 2018;6:1028.

查看原文

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools