Brief report: improved pain relief using intermittent bupivacaine injections at the donor site after breast reconstruction with deep inferior epigastric perforator flap.
BACKGROUND
Deep inferior epigastric perforator flap surgery usually results in postoperative pain from the donor site requiring opioids.


METHODS
We examined the effect of bupivacaine 2.5 mg/mL, 20 mL given every third hour for 72 hours postoperatively through 2 thin catheters placed on the donor site in a double-blind placebo-controlled study consisting of 2 x 20 patients.


RESULTS
The bupivacaine group had significantly reduced pain at rest and during coughing. The placebo group needed 2 to 3 times more opioids in the 72-hour observation period. No difference was seen in the frequency of nausea or the consumption of antiemetic drugs.


CONCLUSIONS
We conclude that intermittent delivery of bupivacaine at the abdominal donor site significantly reduces the postoperative pain and need for narcotic rescue medication.
Department of Plastic and Maxillofacial Surgery, Ullevaal University Hospital, Oslo, Kirkeveien 166, 0407 Oslo, Norway. jorgenutvoll@yahoo.no
Jørgen
J
Utvoll
Marianne
M
Beausang-Linder
Haris
H
Mesic
Johan
J
Raeder
D000082:Acetaminophen / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000627:therapeutic use*; D000932:Antiemetics / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage* / Q000627:therapeutic use*; D002404:Catheterization; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D016462:Mammaplasty; D008875:Middle Aged; D010098:Oxycodone / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy; D013524:Surgical Flaps
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000932:Antiemetics; D000082:Acetaminophen; D010098:Oxycodone; D002045:Bupivacaine