Denis S Valente1. 1. 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.
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-formMcGill PainQuestionnaire 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. CONCLUSION: Preincisional infiltration with bupivacaine results in reduced pain and lower postoperative opioid requirements in the early postoperative phase of pain following breast reduction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.
RCT Entities:
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. CONCLUSION: Preincisional infiltration with bupivacaine results in reduced pain and lower postoperative opioid requirements in the early postoperative phase of pain following breast reduction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.
Authors: Katelyn G Bennett; Brian P Kelley; Alexis D Vick; Jay S Lee; Vidhya Gunaseelan; Chad M Brummett; Jennifer F Waljee Journal: Plast Reconstr Surg Date: 2019-01 Impact factor: 4.730
Authors: Pasquale Sansone; Luca Gregorio Giaccari; Mario Faenza; Pasquale Di Costanzo; Sara Izzo; Caterina Aurilio; Francesco Coppolino; Maria Beatrice Passavanti; Vincenzo Pota; Maria Caterina Pace Journal: BMC Anesthesiol Date: 2020-11-23 Impact factor: 2.217