Acceptable effect of multimodal analgesic treatment after a Bascom cleft lift operation

Dan Med J. 2015 Jan;62(1):A4985.

Abstract

Introduction: Information on multimodal analgesic efficacy in patients undergoing a Bascom cleft lift operation is limited. The aim of this prospective consecutive study was to evaluate early post-operative pain in patients receiving a standardised multimodal analgesic regimen.

Methods: A total of 48 patients undergoing a Bascom cleft lift operation were included over an 8-month period in a day-case set-up. The operation was performed under saddle block. In addition, patients received a standardised multi-modal analgesic regimen consisting of gabapentin, ketorolac, dexamethasone, acetaminophen (paracetamol) and ibuprofen. The intensity of pain was registered preoperatively and at 2, 24, 48 h, and 30 days post-operatively. Nausea, vomiting, dizziness, ability to void, morphine consumption and post-anaesthesia care unit (PACU) time were registered.

Results: Thirty patients were available for analysis. Post-operative visual analogue scale pain scores were low (at 2, 24, and 48 h (median values: 0 (range: 0-40), 25 (0-70), and 30 (0-60), respectively), but changed significantly over time (p < 0.001). The median overall morphine consumption was 0 (range: 0-30). None of the patients experienced vomiting or dizziness. Only two patients reported mild nausea during the stay in the PACU.

Conclusion: This study suggests that the Bascom cleft lift operation is feasible with minimal post-operative pain when using a multimodal analgesic regimen together with saddle block.

Funding: not relevant.

Trial registration: ClinicalTrials.gov: NCT02196727. Regional Ethics Committee Reg. no.: H-3-2013-073. Danish Data Protection Agency Reg. no.: HVH-2013-031, with I-Suite no.: 02408.

Publication types

  • Clinical Trial

MeSH terms

  • Acetaminophen / therapeutic use
  • Adolescent
  • Adult
  • Amines / therapeutic use
  • Analgesics / therapeutic use*
  • Analgesics, Opioid / therapeutic use
  • Antiemetics / therapeutic use
  • Cyclohexanecarboxylic Acids / therapeutic use
  • Dexamethasone / therapeutic use
  • Drug Therapy, Combination / methods
  • Female
  • Gabapentin
  • Humans
  • Male
  • Middle Aged
  • Morphine / therapeutic use
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Pilonidal Sinus / surgery*
  • Postoperative Nausea and Vomiting / drug therapy
  • Prospective Studies
  • Young Adult
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Amines
  • Analgesics
  • Analgesics, Opioid
  • Antiemetics
  • Cyclohexanecarboxylic Acids
  • Acetaminophen
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Morphine
  • Dexamethasone

Associated data

  • ClinicalTrials.gov/NCT02196727