title: Local Infiltration of Liposomal Bupivacaine for Pain Control in Patients Undergoing Mastectomy with Immediate Tissue Expander Reconstruction.
abstract: Mastectomy with immediate tissue expander reconstruction is associated with postoperative pain, nausea, and vomiting. Various techniques of perioperative and postoperative pain control have been described. Our standard of care for postsurgical pain management in patients undergoing mastectomy with immediate tissue expander reconstruction has been preoperative ultrasound-guided paravertebral block. Recent literature demonstrating the opioid-sparing benefits of liposomal bupivacaine has directed two of our plastic surgeons to pilot its use in immediate tissue expander reconstruction. In the accompanying video, we present our technique of intraoperative local infiltration of liposomal bupivacaine into the base of mastectomy skin flaps, serratus fascia, and periaxillary tissue after completion of the mastectomy and before tissue expander placement into the reconstruction pocket.
authors.affiliation: Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Jad M
authors.initials: JM
authors.lastname: Abdelsattar
authors.forename: Amy C
authors.initials: AC
authors.lastname: Degnim
authors.forename: Tina J
authors.initials: TJ
authors.lastname: Hieken
authors.forename: Michel
authors.initials: M
authors.lastname: Saint-Cyr
authors.forename: Judy C
authors.initials: JC
authors.lastname: Boughey
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002045:Bupivacaine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008081:Liposomes; D016462:Mammaplasty / Q000009:adverse effects*; D008408:Mastectomy / Q000009:adverse effects*; D059408:Pain Management; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D015625:Tissue Expansion Devices / Q000009:adverse effects*
chemical_list: D000779:Anesthetics, Local; D008081:Liposomes; D002045:Bupivacaine