Efficacy and safety of bupivacaine instillation through surgical drain in modified radical mastectomy
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 8, Issue 3
Abstract
Background and Aims: modified radical mastectomy (MRM) is the commonly used surgical procedure for operable breast cancer.it involve extensive tissue dissection and infiltration may not have adequate post-operative analgesia. As there is increase in the percentage of women undergoing MRM for cancer breast it is essential to give effective postoperative pain control in these patients. This study has been designed to determine analgesic efficacy and side effects of instillation of bupivacaine in surgical drain for postoperative pain relief in patients undergoing MRM for cancer breast. Method:In this comparative prospective randomized clinical study 60 patients aged 20–65years were divided into three groups A, B and C. All patients were administered general anaesthesia.axillary and chest wall drains were placed at the end of the surgery. Group A received 40ml of 0.25% bupivacaine 20ml through each drain. Group B received 40ml of normal saline 20ml through each drain. Group C was the control with no installation. After instillation of study drug, the drains were clamped for period of 10mins. After extubation, pain score for pain was evaluated using visual analog scale and then 4th hourly till 24 hrs. Rescue analgesia was injection tramadol, if the VAS ≥4. Statistical analysis was performed using software SPSS 18.0, and R environment ver.3.2.2 Results: The mean VAS score was never ≥4 in bupivacaine 0.25% group. There was prolonged duration of analgesia bupivacaine 0.25% group with mean duration of action17.64±2.36hrs compared to saline group 6.55±1.97hrs and control 0.55±1.41hrs. There was a significant difference in the total analgesic requirement and the number of analgesic demands between the groups (P<0.001). Conclusion: The instillation of bupivacaine into surgical drain in modified radical mastectomy is a simpler, cheaper and effective method in providing post-operative analgesia with reduced adverse effect related to the drug and minimal or no complication associated with instillation of the drug.
Authors and Affiliations
Vinutha M, Rashmi NR, VB Gowda Gowda
Keywords
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- EP ID EP453359
- DOI 10.26611/10158312
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