title: Decreased narcotic use with an implantable local anesthetic catheter after deep inferior epigastric perforator flap breast reconstruction.
abstract: This study evaluated narcotic use after deep inferior epigastric perforator flap breast reconstruction when a local anesthetic catheter was used. A retrospective analysis was performed comparing 40 consecutive control patients (no catheter) to 40 consecutive study patients who had received a pain pump catheter. The catheter was left in the abdomen for 72 hours. Using an equianalgesic table, all narcotic doses (oral and intravenous) were converted to intravenous morphine equivalents. Initial average 24-hour morphine requirement for the control group was 42 mg compared with 33 mg for the study group (P = 0.04). Total hospitalization average morphine requirement for the control group was 71 mg compared with 55 mg for the catheter group (P = 0.03). The use of an implantable local anesthetic catheter placed in the abdomen can decrease narcotic use in the postoperative period after deep inferior epigastric perforator flap breast reconstruction.
authors.affiliation: Department of Plastic Surgery, Georgetown University Hospital, 1st Floor PHC, 3800 Reservoir Rd, Washington, DC 20007, USA. jayboehmler@mac.com
authors.forename: James H
authors.initials: JH
authors.lastname: Boehmler
authors.forename: Mark L
authors.initials: ML
authors.lastname: Venturi
authors.forename: Maurice Y
authors.initials: MY
authors.lastname: Nahabedian
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000772:Anesthesia, Local; D001943:Breast Neoplasms / Q000601:surgery*; D002408:Catheters, Indwelling; D019074:Epigastric Arteries; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*
chemical_list: D000701:Analgesics, Opioid