Reduction or elimination of postoperative pain medication after mastectomy through use of a temporarily placed local anesthetic pump vs. control group.
OBJECTIVE
We evaluated the efficacy of a temporarily placed porous catheter with continuous application of a local anaesthetic(ON-Q( by l-Flow-Corp., Lake Forest, CA, USA) post mastectomy vs. patients without this device regarding postoperative need for opioid medication.


METHODS
At Fayette Medical Center, Alabama, a retrospective evaluation of all consecutive mastectomies (n = 49) within a five-year-period from 1/1997-12/2001 and statistical analysis regarding postoperative need for opioids was performed. The ON-Q pain management pump with continuous 0.25% Sensorcaine (Bupivacaine and Epinephrine) application for about 72 h (n- 22) was compared vs. a control group without pain management pump (n- 27).


RESULTS
There were no statistical significant differences regarding patient demographics in both groups. Patients in the ON-Q group with no need of postoperative opioid pain medication were: 18.2 vs. 3.7 % (P - 0.1), no need for opioids after postoperative day 1: 68.2% vs. 11.1 % (P 0.001), total opioids usage in dose equivalents (DE): 1.25 vs. 3.36 DE (-62.8%) (P-0.016), opioids usage postoperative day 1: 0.65 vs. 1.82 DE (-64.6%) (P - 0.016),opioids usage postoperative day 2: 0.24 vs. 0.75 DE (-68.4%)(P - 0.011). The length of stay in hospital was 2.35 vs. 2.93 days(n.s.), and postoperative stay in PACU: 384 vs. 43.3 min (n. s.).OR time for placement of catheter and pump is only slightly increased. No complications occurred.


CONCLUSIONS
Use of an ON-Q pain management pump could significantly reduce or even eliminate postoperative need for opioids analgesics.
Morrison
J E
JE
Jacobs
V R
VR
D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000601:surgery; D018567:Breast Neoplasms, Male / Q000601:surgery; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008408:Mastectomy / Q000009:adverse effects*; D010149:Postoperative Pain / Q000517:prevention & control*; D012189:Retrospective Studies
D000701:Analgesics, Opioid; D000779:Anesthetics, Local