01917nas a2200157   4500008003900000245015300039210006900192260000800261300001400269490000700283520138500290100001201675700001301687700001401700856004501714       1999                          d00aBone marrow harvesting using EMLA (eutectic mixture of local anaesthetics) cream, local anaesthesia and patient-controlled analgesia with alfentanil0 aBone marrow harvesting using EMLA eutectic mixture of local anae  cMay  a941 - 9450 v233 aBone marrow harvesting (BMH) was performed on 40 consecutive allogeneic or autologous donors using EMLA (eutectic mixture of local anaesthetics), local anaesthesia (LA) and patient-controlled analgesia with alfentanil (PCA-A), The effect of alkalinizing the LA solution on reducing pain during LA infiltration in the presence of EMLA was also investigated. EMLA 10 g with occlusive dressing was applied to the harvest sites at least 60 min before BMH, The PCA device was programmed to deliver an intravenous loading dose of 15 mu g/kg alfentanil, followed by a background alfentanil infusion of 0.05 mu g/kg/min. Demand dose was 4 mu g/kg and lockout time was 3 min. Donors were randomized to receive either alkalinized (n = 19) or non-alkalinized (n=21) LA solution (lignocaine 1% with 1:100 000 adrenaline). While post-operative nausea and vomiting were the only side-effects, all donors in both groups reported satisfactory pain scores during LA infiltration and satisfactory overall intra-operative comfort scores. They completed BMH using either regimen successfully, found this technique acceptable and would recommend this form of anaesthesia to others. Alkalinizing the LA solution did not significantly improve the pain scores during LA infiltration in the presence of EMLA, In conclusion, BMH can be performed safely using EMLA, LA and PCA-A without major complications.1 aNg, H N1 aSim, K M1 aBoey, S K  uhttps://notifylibrary.org/reference/1082