Does a continuous local anaesthetic pain treatment after immediate tissue expander reconstruction in breast carcinoma patients more efficiently reduce acute postoperative pain - a prospective randomised study

World Journal of Surgical Oncology

Uros Ahcan³  Nikola Besic²  Branka Strazisar¹ 

[1] Department of Anaesthesiology, Institute of Oncology, Zaloska 2, Ljubljana SI-1000, Slovenia;Department of Surgical Oncology, Institute of Oncology, Zaloska 2, Ljubljana SI-1000, Slovenia;Department of Plastic Surgery and Burns, University Clinical Centre Ljubljana, Zaloska 7, Ljubljana SI-1000, Slovenia

关键词: Elastomeric pump;    Wound infusion of local anaesthetic;    Pain treatment;    Primary reconstruction with tissue expander;    Breast carcinoma;   

Others  :  820532
DOI  :  10.1186/1477-7819-12-16

 received in 2013-11-03, accepted in 2013-12-25,  发布年份 2014

【 摘 要 】

Background

Immediate breast reconstruction with an expander is a reasonable option for properly selected patients. After reconstruction, patients have severe postoperative pain, which responds poorly to opioids. Our aim was to evaluate if continuous wound infusion of a local anaesthetic into the surgical wound reduces postoperative pain, consumption of opioids and incidence of chronic pain compared to standard intravenous piritramide after primary breast reconstruction in breast carcinoma patients.

Methods

Altogether, 60 patients were enrolled in our study; one half in the group with wound infusion of a local anaesthetic, and the other half in the standard (piritramide) group. Parameters measured included: pain intensity (visual analogue scale), drug requirements, alertness, hospitalisation, side-effects and late complications. A p-value of < 0.05 was considered statistically significant.

Results

In the recovery room, the test group reported less acute pain at rest (P = 0.03) and at activity (P = 0.01), and on the day of the surgical procedure they reported less pain at activity (P = 0.003). Consumption of piritramide and metoclopramide was lower in this group (P < 0.0001), but their alertness after the surgical procedure was higher compared to the standard group (P < 0.001). After three months, the test group reported less chronic pain (P = 0.01).

Conclusions

After primary tissue expander breast reconstruction, wound infusion of a local anaesthetic significantly reduces acute pain and enables reduced opioid consumption, resulting in less postoperative sedation and reduced need for antiemetic drugs. Wound infusion of a local anaesthetic reduces chronic pain.

【 授权许可】

   
2014 Strazisar et al.; licensee BioMed Central Ltd.

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