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Correspondence  |   October 2005
Iliac Crest Bone Harvest: Should We Really Use Continuous Infusion of Ropivacaine?
Author Affiliations & Notes
  • Alain Borgeat, M.D.
    *
  • *Balgrist University Hospital, Zurich, Switzerland.
Article Information
Correspondence
Correspondence   |   October 2005
Iliac Crest Bone Harvest: Should We Really Use Continuous Infusion of Ropivacaine?
Anesthesiology 10 2005, Vol.103, 901. doi:
Anesthesiology 10 2005, Vol.103, 901. doi:
In Reply:—
We thank Dr. Geoffroy et al.  for their interest in our study and the opportunity to clarify the points mentioned by these authors: We clearly disagree with the assessment that our study1 is a simple repetition of the study of Brull et al.  2 Besides many methodologic differences (historic control group, different operations within the study group, close proximity of the operation site to the iliac crest, and others), the major difference is the application of repeated bupivacaine boluses in the study of Brull et al.  compared with a continuous infusion of ropivacaine in ours. The number of patients in our study was calculated to demonstrate reduced pain intensity at rest during the first 48 h postoperatively. This was clearly stated in our article. Because pain was assessed every 8 h from t0 to t48, a Bonferroni correction for multiple comparisons was performed to avoid an increase of a type I risk error. This point was also clearly stated in the article.
Regarding the question of pain therapy after discharge, it should read “3 months” instead of “3 weeks” (page 393, fifth line of the second column). We apologize for having produced confusion with this. We agree with Geffroy et al.  that it would have been a wonderful way to strengthen our study to include data on the social consequences of persistent or relieved pain at the iliac crest at 3 months. However, these questions were not part of our original study protocol, and thus we did not include retrospective data in our prospective investigation.
*Balgrist University Hospital, Zurich, Switzerland.
References
Blumenthal S, Dullenkopf A, Rentsch K, Borgeat A: Continuous infusion of ropivacaine for pain relief after iliac crest bone grafting for shoulder surgery. Anesthesiology 2005; 102:392–7Blumenthal, S Dullenkopf, A Rentsch, K Borgeat, A
Brull SJ, Lieponis JV, Murphy MJ, Garcia R, Silverman DG: Acute and long-term benefits of iliac crest donor site perfusion with local anesthetics. Anesth Analg 1992; 74:145–7Brull, SJ Lieponis, JV Murphy, MJ Garcia, R Silverman, DG