The Efficacy of Continuous Local Anesthetic Infiltration in Breast Surgery: Reduction Mammaplasty and Reconstruction

Abstract

The continuous infiltration of local anesthetic with an infusion pump represents another tool for pain management in surgical patients.

Placebo-controlled trial of local anaesthesia for treatment of pain after breast reconstruction

“…Continuous infusion of local anaesthesia for treating postoperative pain has often been studied, and bupivacaine has in some studies been shown to reduce median pain scores and cumulative pain medication after breast reconstruction with tissue expanders [7], after autologous breast reconstruction [8], and after axillary lymph-node dissection [9]. A study of continuous bupivacaine through a catheter in the operation site for 48 hours after transverse rectus abdominis muscle (TRAM) flap breast reconstruction did not measure intensity of pain but showed reduced narcotic requirements and shortened hospital stay [10].…”

Evolving Role of Local Anesthetics in Managing Postsurgical Analgesia

“…85 Studies of continuous wound infiltration (infusion into tissues within and surrounding the surgical field) of local anesthetics were conducted across a range of surgical models to evaluate the effect of continuous local anesthetic infusion on pain scores, opioid use, and hospital stay. To date, the results were equivocal, with some studies finding lower pain scores, 86-95 opioid consumption, 87,89,[92][93][94] and/or length of hospital stay 89,91,[93][94][95][96] attributable to continuous wound infiltration, whereas others failed to find benefit on any of these outcome measures. [97][98][99][100][101][102][103] These variable results may be because of differences in the positioning of the catheter or dose of local anesthetic.…”

Cost-Effectiveness Analysis of Levobupivacaine 0.5 %, a Local Anesthetic, Infusion in the Surgical Wound After Modified Radical Mastectomy

“…However, this period is not completely fixed in the literature and there is a variety of possibilities. Several studies [6,[18][19][20][21][41][42][43][44][45][46][47][48] have administered these anesthetics from 24 h to 10 days. Pacik et al [5] used the infusion of a local anesthetic in 200 mammoplasties, remarking that 172 patients were administered the infusion for 24 h and 28 patients for 48 h. The study by Rawal et al [47] is very significant in terms of time of administration of the pump.…”