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
Identifieur interne : 006188 ( Ncbi/Checkpoint ); précédent : 006187; suivant : 006189Does 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
Auteurs : Branka Strazisar [Slovénie] ; Nikola Besic [Slovénie] ; Uros Ahcan [Slovénie]Source :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2014.
Abstract
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.
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.
In the recovery room, the test group reported less acute pain at rest (
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.
Url:
DOI: 10.1186/1477-7819-12-16
PubMed: 24433317
PubMed Central: 3899444
Affiliations:
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<author><name sortKey="Besic, Nikola" sort="Besic, Nikola" uniqKey="Besic N" first="Nikola" last="Besic">Nikola Besic</name>
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<author><name sortKey="Ahcan, Uros" sort="Ahcan, Uros" uniqKey="Ahcan U" first="Uros" last="Ahcan">Uros Ahcan</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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</title>
<author><name sortKey="Strazisar, Branka" sort="Strazisar, Branka" uniqKey="Strazisar B" first="Branka" last="Strazisar">Branka Strazisar</name>
<affiliation wicri:level="1"><nlm:aff id="I1">Department of Anaesthesiology, Institute of Oncology, Zaloska 2, Ljubljana SI-1000, Slovenia</nlm:aff>
<country xml:lang="fr">Slovénie</country>
<wicri:regionArea>Department of Anaesthesiology, Institute of Oncology, Zaloska 2, Ljubljana SI-1000</wicri:regionArea>
<wicri:noRegion>Ljubljana SI-1000</wicri:noRegion>
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<author><name sortKey="Besic, Nikola" sort="Besic, Nikola" uniqKey="Besic N" first="Nikola" last="Besic">Nikola Besic</name>
<affiliation wicri:level="1"><nlm:aff id="I2">Department of Surgical Oncology, Institute of Oncology, Zaloska 2, Ljubljana SI-1000, Slovenia</nlm:aff>
<country xml:lang="fr">Slovénie</country>
<wicri:regionArea>Department of Surgical Oncology, Institute of Oncology, Zaloska 2, Ljubljana SI-1000</wicri:regionArea>
<wicri:noRegion>Ljubljana SI-1000</wicri:noRegion>
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<author><name sortKey="Ahcan, Uros" sort="Ahcan, Uros" uniqKey="Ahcan U" first="Uros" last="Ahcan">Uros Ahcan</name>
<affiliation wicri:level="1"><nlm:aff id="I3">Department of Plastic Surgery and Burns, University Clinical Centre Ljubljana, Zaloska 7, Ljubljana SI-1000, Slovenia</nlm:aff>
<country xml:lang="fr">Slovénie</country>
<wicri:regionArea>Department of Plastic Surgery and Burns, University Clinical Centre Ljubljana, Zaloska 7, Ljubljana SI-1000</wicri:regionArea>
<wicri:noRegion>Ljubljana SI-1000</wicri:noRegion>
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<series><title level="j">World Journal of Surgical Oncology</title>
<idno type="eISSN">1477-7819</idno>
<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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.</p>
</sec>
<sec><title>Methods</title>
<p>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.</p>
</sec>
<sec><title>Results</title>
<p>In the recovery room, the test group reported less acute pain at rest (<italic>P</italic>
= 0.03) and at activity (<italic>P</italic>
= 0.01), and on the day of the surgical procedure they reported less pain at activity (<italic>P</italic>
= 0.003). Consumption of piritramide and metoclopramide was lower in this group (<italic>P</italic>
< 0.0001), but their alertness after the surgical procedure was higher compared to the standard group (<italic>P</italic>
< 0.001). After three months, the test group reported less chronic pain (<italic>P</italic>
= 0.01).</p>
</sec>
<sec><title>Conclusions</title>
<p>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.</p>
</sec>
</div>
</front>
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<author><name sortKey="Davidson, Jsd" uniqKey="Davidson J">JSD Davidson</name>
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<author><name sortKey="Von Smitten, K" uniqKey="Von Smitten K">K Von Smitten</name>
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<author><name sortKey="Hietanen, P" uniqKey="Hietanen P">P Hietanen</name>
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<author><name sortKey="Kataja, M" uniqKey="Kataja M">M Kataja</name>
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