Comparison of bupivacaine moistened dressing and conventional dressing for pain relief on skin graft donor sites.

OBJECTIVE To compare the effectiveness of bupivacaine moistened dressing and conventional dressing in patients requiring split thickness skin graft for reconstruction of various defects. STUDY DESIGN Randomized controlled trial. PLACE AND DURATION OF STUDY Department of Plastic Surgery and Burns Unit, Mayo Hospital, King Edward Medical University, Lahore, from January 2011 to January 2013. METHODOLOGY One hundred and fifty patients requiring split thickness skin grafting for various soft tissue defects were divided into two groups A and B, with 75 patients in each group. In Group A, skin graft donor site dressing was kept moist with 12 mL/100 cm2 of 0.25% bupivacaine solution and in Group B, dressing was moistened with same amount of normal saline. Outcome was measured by calculating rescue analgesia requirements in the two groups after 24 hours. Significance was determined by comparing analgesia sparing effect of each dressing using chi-square test. RESULTS In Group A, 5 out of 75 (6.7%) patients required rescue analgesia. In Group B, 72 out of 75 (96%) patients required rescue analgesia (p < 0.0001). There was 93.3% effectiveness of bupivacaine soaked dressing while only 4% effectiveness of conventional dressing. CONCLUSION Bupivacaine soaked dressing is much more effective in pain relief and in reducing the requirement of rescue analgesia, in early postoperative period, at split thickness skin graft donor site compared to the conventional dressing.