Анестезия и клинические исследования
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Assessment of Post Operative Analgesia in Modified Radical Mastectomy Patients Using Surgical Wound Irrigation with 0.25% Bupivacaine

Muhammed C Shafi

Modified Radical Mastectomy (MRM) is the most common surgical procedure for operable breast malignancies. Various strategies like non-steroidal anti-inflammatory drugs, opioids, peripheral nerve blocks, wound infiltration with local anaesthetics, thoracic epidural anaesthesia were found to have significantly improved the postoperative pain. An alternative technique that has widespread applicability is the insertion of catheters to allow for continuous infusions of local anaesthetics into the surgical wound at the end of the procedure. Continuous wound irrigation catheters with local anaesthetic drugs confer several benefits, including improved analgesia, reduced opioid use and its side effects, increased patient satisfaction and reduced hospital stay. Direct application of local anaesthetic to wounds directly block transmission of pain from nociceptive afferents from the wound surface; reduce release of inflammatory mediators from neutrophils, reduce neutrophil adhesion to the endothelium, reduce formation of free oxygen radicals and decrease oedema formation.