title: Preemptive analgesia with bupivacaine in reduction mammaplasty: a prospective, randomized, double-blind, placebo-controlled trial.
abstract: BACKGROUND
  Preincisional analgesia is an antinociceptive treatment that prevents altered central excitability from high-intensity noxious stimuli. To determine the analgesic efficacy of preoperative infiltration with bupivacaine for reduction mammaplasty, a randomized, double-blind, placebo-controlled trial was designed.
  
  
  METHODS
  Women with mammary hypertrophy were allocated randomly to one of two study groups. Patients in group I received preincision infiltration with bupivacaine into each breast after general anesthesia. Group II patients received similar injections of saline injection alone after general anesthesia.
  
  
  RESULTS
  Visual analogue pain score, verbal pain score, and short-form McGill Pain Questionnaire scores were higher in group II patients until 22 hours after surgery (p < 0.008). Patients in the saline group had higher intravenous meperidine consumption for 22 hours postoperatively and solicited opioids before the patients in the bupivacaine group (p < 0.001). The difference between groups was statistically significant.
  
  
  CONCLUSIONS
  Preincisional infiltration with bupivacaine results in reduced pain and lower postoperative opioid requirements in the early postoperative phase of pain following breast reduction.
  
  
  METHODS
  Therapeutic, I.
authors.affiliation: Porto Alegre, Brazil From the Division of Plastic Surgery and Reconstructive Microsurgery, Santa Casa Hospital; and the Division of Plastic Surgery, Mãe de Deus Health System.
authors.forename: Denis S
authors.initials: DS
authors.lastname: Valente
mesh_terms: D000328:Adult; D000777:Anesthetics; D002045:Bupivacaine; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016462:Mammaplasty; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies
chemical_list: D000777:Anesthetics; D002045:Bupivacaine