Bone marrow harvesting using local anaesthesia and PCA-alfentanil: A feasible alternative to general or regional anaesthesia

We examined the feasibility of combined use of local anaesthesia (LA) and patient-controlled analgesia with alfentanil (PCA-alfentanil) for bone marrow harvesting (BMH) in 16 consecutive in-patient donors (nine allogeneic and seven autologous). A loading dose of alfentanil 15 mu g/kg was delivered at the time of skin preparation followed by a background infusion of alfentanil 0.05 mu g/kg/min. On-demand bolus doses of alfentanil were 4 mu g/kg with lockout intervals of 3 min. Local anaesthesia was achieved using 1% lignocaine (up to 7 mg/kg) with 1:200000 adrenaline, All donors were mildly sedated during BMH, tolerated the procedure well, and experienced no cardiovascular or respiratory complications, Post-operative nausea and vomiting were the only side-effects, All donors indicated that the combined use of LA with PCA-alfentanil was acceptable for BMH, Our preliminary results suggest that although optimal PCA settings have yet to be determined, this technique may be a feasible and effective alternative for BMH in situations where general or regional anaesthesia is undesirable.