Evaluation of the hemodynamic effect of bupivacaine wound instillation in modified radical mastectomy
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 8, Issue 3
Abstract
Background and aim: Breast cancerare a leading cause of cancer death among women. Modified Radical Mastectomy (MRM) is the commonest surgery done for operable breast malignancies. Majority of operated patients will experience some degree of postoperative pain. Poorly managed postoperative pain may cause activation of the stress response leading to stress over several major organ. This study has been designed to determine hemodynamic effects of bupivacaine wound instillation for postoperative pain relief in patients undergoing MRM for cancer breast. Methods: In this comparative prospective randomized clinical study 66 patients aged 30–65years were divided into three groups D, S and C. All patients received general anesthesia.Axillary and chest wall drains were placed at the end of surgery. Group D received 40ml of 0.25% bupivacaine 20ml through each drain. Group S 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 4thhourly till 24 hrs. Rescue analgesia was injection tramadol, if the VAS ≥4.The patient’s hemodynamic parameters were monitored postoperatively 4th hourly for 24 hrs. Statistical analysis was performed using software SPSS 18.0, and R environment ver.3.2.2. Result: the parameters monitored were pulse rate, mean arterial pressure and SpO2%. The mean of these hemodynamic parameters was calculated and compared with the other groups. It was found to be statistically not significant.Conclusion: The wound instillation of bupivacaine into surgical drain in modified radical mastectomy provides an effective post-operative analgesia with better hemodynamic stability and 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
Keywords
Related Articles
- EP ID EP453373
- DOI -
- Views 140
- Downloads 0
Comparison of post-operative analgesic efficacy of bupivacaine and ropivacaine using ultrasound guided oblique subcostal transverse abdominis plane block in open cholecystectomy under general anaesthesia
Background: Cholecystectomy involves upper abdominal incision with considerable postoperative pain. Adequate postoperative analgesia has to be provided to prevent major pulmonary complications in the postoperative period...
Comparative study of intrathecal bupivacaine with buprenorphine and bupivacaine with tramadol
Background: Intrathecal local anaesthetic provide adequate sensory and motor block necessary for all infra umbilical surgeries. Aim: The study is to compare Buprenorphine and Tramadol in their efficacy as adjuvants to su...
A comparative study on two doses of clonidine 45mcg Vs 60mcg added to 0.5% hyperbaric bupivacaine given intrathecally for infra umbilical surgeries
Background: This study was designed to evaluate the addition of two doses of clonidine ( 45 µg and 60µg) added to hyperbaric bupivacaine (0.5%) 2.75ml in spinal anaesthesia for sub umbilical surgeries. Aim of Study: Time...
Comparison of haemodynamic changes during laproscopic surgery and postoperative analgesia while using fentanyl and butorphanol as a premedication
Back ground and Aim: Laproscopy surgery has advantages like minimal tissue trauma, reduced post operative complication and early recovery to normal activity. Laproscopy requires pneumoperitoneum which causes various card...
A comparative study between midazolam, ketamine and combination of both as a premedication in pediatric surgeries
Background: Midazolam andketamine are widely used oral pre anesthetic medication. This study was planned to compare midazolam and ketamine alone with combination of midazolam and ketamine as oral pre-anesthetic medicatio...