Efficiency of infiltration with bupivacain after modified radical mastectomy.
BACKGROUND
Pre-incisional infiltration of anaesthetic is proven to reduce postoperative pain in breast cancer surgery. However, studies of post-incisional infiltration for modified radical mastectomy are rare. The purpose of this study was to investigate whether post-incisional infiltration with bupivacaine provides improved postoperative pain relief and a cost-effective benefit.


METHODS
This is a retrospective study. Between January 2006 and May 2008, 139 patients who received modified radical mastectomy were recruited to participate in the study. Patients receiving local infiltration received bupivacaine (0.5% bupivacaine, 5 ml diluted to 10 ml with distilled water) injected into the dermis surrounding the incision after wound suture. Pain intensity was evaluated using a Visual Analogue Scale (VAS) score and measurement of the required doses of meperidine and acetaminophen. The pain score was recorded every eight hours for three days.


RESULTS
All patients were female. Seventy-two patients received local infiltration with bupivacaine after wound suture and 67 patients did not. There were no significant differences between the two patient groups in age, body weight and height, length of general anaesthesia and operative time. Hospital stay was significantly shorter for patients receiving local infiltration of bupivacaine. The VAS score was higher up to 16 hours post-surgery for patients who did not receive local infiltration. Meperidine and acetaminophen consumption was less for patients who received local infiltration (P = 0.010).


CONCLUSIONS
Post-incisional wound infiltration with bupivacaine can relieve pain during the first 16 hours after surgery and shorten hospital stay, and it provides a cost-effective benefit.
Department of Surgery, Division of General Surgery, National Defence Medical Centre and Tri-Service General Hospital, Taiwan, Republic of China.
T J
TJ
Lu
J H
JH
Chen
H M
HM
Hsu
C T
CT
Wu
J C
JC
Yu
D000082:Acetaminophen / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000191:economics; D001943:Breast Neoplasms / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007902:Length of Stay / Q000191:economics; D015411:Mastectomy, Modified Radical / Q000379:methods; D008614:Meperidine / Q000008:administration & dosage; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000082:Acetaminophen; D008614:Meperidine; D002045:Bupivacaine