title: Interpleural analgesia in breast reconstruction.
abstract: To investigate the safety and efficacy of interpleural analgesia for postoperative pain control in patients having breast reconstruction we did a retrospective audit of 114 women who had had their breasts reconstructed by the same team. A group of 22 women given morphine postoperatively acted as a historical control. Ninety-two women were given continuous postoperative interpleural bupivacaine with free access to morphine. We recorded complications, morphine consumption, postoperative pain, nausea and vomiting scores, and duration of hospital stay. There was one episode of air entrapment. Morphine consumption was significantly reduced in the interpleural group (p<0.000). Pain scores were similar in all groups (p=0.11). Nausea and vomiting scores were significantly lower in the interpleural group (p=0.04) and hospital stay was shorter in the interpleural group but not significantly so (p<0.9). We conclude that interpleural analgesia improves the quality of postoperative care in breast reconstruction with latissimus dorsi flaps.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Northern General Hospital, Sheffield, United Kingdom. steven.colpaert@skynet.be
authors.forename: Steven D M
authors.initials: SD
authors.lastname: Colpaert
authors.forename: Paul D
authors.initials: PD
authors.lastname: Smith
authors.forename: Chris M
authors.initials: CM
authors.lastname: Caddy
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use; D000068579:Celecoxib; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007902:Length of Stay; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D035422:Pleural Cavity; D011720:Pyrazoles / Q000627:therapeutic use; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D009020:Morphine; D000068579:Celecoxib; D002045:Bupivacaine