Efficacy of subcutaneous and topical local anaesthesia for pain relief after resection of malignant breast tumours.
OBJECTIVE
Infiltration and topical application of local anaesthetics close to the surgical wound may be used to prevent postoperative pain. We evaluated the efficacy of these treatments after breast surgery for cancer.


METHODS
Double-blind randomised trial with two treatment groups and one control group.


METHODS
University hospital, Sweden.


METHODS
Patients were allocated to treatment with bupivacaine infiltration (n = 29), topical application of lignocaine/prilocaine (n = 31), or no local treatment (n = 30).


METHODS
Difference and time related patterns in pain scores measured on a visual analogue scale (VAS), and morphine consumption. RESULTS. None of the local anaesthetics significantly reduced the VAS score or morphine consumption. However, fewer patients in the anaesthetic groups had high VAS scores than controls, the 75 centile for the mean score after operation being 2.7, 2.0 and 2.1 for the controls, infiltration, and topical anaesthetic groups, respectively. The controls had higher scores from 6 hours postoperatively onwards. The corresponding median morphine consumption was 24.5, 18.5, and 16.2 mg. CONCLUSIONS. Local anaesthesia slightly reduced the overall pain scores and the morphine consumption, but was of potential clinical value only in the patients who had the highest pain scores.
Pettersson
N
N
Department of Surgery, Huddinge University Hospital, Stockholm, Sweden.
Perbeck
L
L
Hahn
R G
RG
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D000077442:Lidocaine, Prilocaine Drug Combination; D015412:Mastectomy, Segmental / Q000009:adverse effects; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011318:Prilocaine / Q000008:administration & dosage*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D009020:Morphine; D008012:Lidocaine; D002045:Bupivacaine