目的：尽管在头颈部重建中使用肩胛骨尖游离皮瓣（STFF）后的功能和美学效果，以及相关的供体部位发病率，已经被广泛描述，缺乏有关急性术后供体部位疼痛管理的数据.这项研究的目的是探索使用微型导管在使用STFF重建后使用局部麻醉药进行供体部位疼痛管理。
方法：前瞻性纳入使用STFF进行头颈部重建的患者，通过在手术过程中放置在供体部位的神经导管，在患者恢复意识之前以及术后8,16和24小时注射一团氯硝胺。每次给药之前和给药后40分钟，在数字评定量表(NRS;0-10)上评估供体部位疼痛.
结果：研究人群包括20名患者（40-88岁）。在8小时，注射前后的疼痛评分分别为0-10（平均3.35）和0-5（平均1.25），分别。16小时时，注射前后疼痛评分分别为0~8分(平均2.55分)和0~4分(平均0.55分),分别。在24小时，注射前后疼痛评分分别为0-8分(平均1.30分)和0-4分(平均0.30分),分别。
结论：统计学分析证实在给药8、16和24小时前后疼痛评分之间存在显著差异(分别为p<0.001、p<0.001和p=0.003)。用于局部麻醉给药的微型导管代表了STFF采集头颈部重建后疼痛控制的有效策略。
OBJECTIVE: Although functional and esthetic results after the use of a scapular tip free flap (STFF) in head and neck reconstruction, and the related donor-site morbidity, have been extensively described, data regarding acute postoperative donor-site pain management are lacking. Purpose of this study is to explore the use of mini-catheters to administer local anesthetics for donor-site pain management after reconstruction using STFF.
METHODS: Patients who underwent head and neck reconstruction using a STFF were prospectively enrolled and, through a perineural catheter placed in the donor site during the surgical procedure, a bolus of chirochaine was injected before the patient regained consciousness and at 8, 16, and 24 h postoperatively. Before and 40 min after each dose administration, donor-site pain on a numerical rating scale (NRS; 0-10) was evaluated.
RESULTS: Study population consisted of 20 patients (40-88 years). At 8 h, the pain scores before and after the injection were 0-10 (mean 3.35) and 0-5 (mean 1.25), respectively. At 16 h, the pain scores before and after the injection were 0-8 (mean 2.55) and 0-4 (mean 0.55), respectively. At 24 h, the pain scores before and after the injection were 0-8 (mean 1.30) and 0-4 (mean 0.30), respectively.
CONCLUSIONS: Statistical analysis confirmed a significant difference between the pain scores before and after administration at 8, 16, and 24 h (p < 0.001, p < 0.001, and p = 0.003, respectively). Mini-catheters for local anesthetic administration represent an effective strategy for pain control after STFF harvesting for head and neck reconstruction.
