Анестезия и клинические исследования
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Local Anesthetic Irrigation and Postoperative Pain in Patients Undergoing Breast Augmentation

Essam Manaa

Objective: To determine if the irrigation of the breast cavity with local anesthetics in patients who undergo breast augmentation surgery reduces rescue analgesic requirements and postoperative pain intensity level, measured with the visual analogue scale (VAS).

Methods: This study is a Placebo controlled non randomized clinical trial. In the intervention group (group 1) the breast cavity was irrigated with 1% lidocaine with epinephrine (7 mg/kg), 0.5% bupivacaine (3 mg/kg) and normal saline solution. In the second control group (group 0) the breast cavity was irrigated with saline solution. Anesthetic and analgesic techniques were standardized. The type (morphine, hydromorphone and meperidine) and total required dose of opioid rescue analgesic medication in the Post Anesthetic Care Unit (PACU) were also registered. Postoperative pain intensity level was also registered at the moment of consciousness recovery, thirty minutes, the first hour, two, six and twenty four hours of postoperative period.

Results: There was a difference in the number of patients requiring opioid rescue analgesia with morphine at PACU (p<0.01), 10% in the intervention group versus 50% in the control group. Likewise, there was difference in pain intensity level (p<0.01).

Conclusions: Local anesthetic irrigation in patients who underwent breast augmentation surgery reduces opioid rescue analgesia requirements and postoperative pain intensity level.