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

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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
- Systematic literature review of topical local anaesthesia or analgesia to donor site wounds
- Burns & Trauma 2022年10卷第1期
- 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
  中图分类号：
- 纸质出版日期：2022，
  
  网络出版日期：2022-9-19，
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Systematic literature review of topical local anaesthesia or analgesia to donor site wounds[J]. Burns & Trauma, 2022,10(1).

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
Systematic literature review of topical local anaesthesia or analgesia to donor site wounds[J]. Burns & Trauma, 2022,10(1). DOI： 10.1093/burnst/tkac020.

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

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