Multiple intramuscular ropivacaine injections to donor sites reduces pain in deep inferior epigastric artery perforator flap breast reconstruction.

Autor: Bae J; Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Mediclne, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea., Shin DR; Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea., Sohn JY; Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Mediclne, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea., Park JW; Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Republic of Korea. Electronic address: burnscar@naver.com., Woo KJ; Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Mediclne, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea. Electronic address: economywoo@gmail.com.
Jazyk: angličtina
Zdroj: Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2024 Nov; Vol. 98, pp. 82-90. Date of Electronic Publication: 2024 Aug 21.
DOI: 10.1016/j.bjps.2024.08.048
Abstrakt: Introduction: Local anesthetic infiltration at the surgical site has been studied in various surgical disciplines; however, its impact on deep inferior epigastric artery perforator (DIEP) flap breast reconstruction has not been previously assessed. This study aimed to evaluate the effects of multiple intramuscular ropivacaine injections on donor site pain during DIEP flap breast reconstruction.
Methods: The study included 65 patients who received local ropivacaine injections during DIEP reconstructions between March 2022 and February 2023, compared to 55 patients who underwent surgeries without ropivacaine from October 2018 to July 2020. A total of 20 cc of 0.75% ropivacaine solution was evenly administered at 20 sites along the abdominal wall muscles. The effect of intramuscular ropivacaine injection on postoperative visual analog scale (VAS) was evaluated using linear mixed-effect model. Opioid consumption and hospital days were also compared.
Results: The daily median VAS score was lower in the ropivacaine group (all p-values < 0.001). When analyzed using a linear mixed-effects model, those who received ropivacaine had significantly lower VAS scores over the first 5 days postoperatively (p-value < 0.001). The rate of VAS score decline was also faster in the ropivacaine group over the first 24 h postoperative (p-value = 0.045). Although opioid consumption was comparable between the groups, those receiving ropivacaine had significantly shorter hospital stay (p-value = 0.001) and no complications related to the injections were observed.
Conclusion: Multiple intramuscular injections of ropivacaine to the donor site may reduce postoperative pain and shorten hospital stays, without increasing opioid consumption.
(Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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