Pre-incision infiltration with lidocaine reduces pain and opioid consumption after reduction mammoplasty
| Autor: | Kevin C. Dennehy, Anne C. P. Lui, Ola P. Rosaeg, Nicholas Cicutti, Michael Bell, Barbara Krepski |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
medicine.medical_specialty Epinephrine Lidocaine Mammaplasty medicine.medical_treatment Dermatologic Surgical Procedures Sodium Chloride Reduction Mammoplasty Bolus (medicine) Double-Blind Method medicine Humans Breast Anesthetics Local Saline Pain Measurement Skin Pain Postoperative Morphine business.industry Analgesia Patient-Controlled General Medicine Adrenergic Agonists Patient Discharge Surgery Analgesics Opioid Anesthesiology and Pain Medicine Opioid Anesthesia Anesthesia Recovery Period Injections Intravenous Postoperative Nausea and Vomiting Female business Anesthesia Local medicine.drug |
| Zdroj: | Regional Anesthesia and Pain Medicine. 23:575-579 |
| ISSN: | 1098-7339 |
| DOI: | 10.1016/s1098-7339(98)90084-0 |
| Popis: | To determine the analgesic efficacy of preoperative tumescent infiltration with lidocaine for reduction mammoplasty.Women with mammary hypertrophy were randomly allocated to one of two study groups in a double-blind clinical trial. Patients in group 1 received preincision infiltration with 5 mL/kg of 0.35% lidocaine with 1:1,000,000 epinephrine into each breast after induction of general anesthesia. Group 2 patients received similar injections of 5 mL/kg of saline with 1:1,000,000 epinephrine. Intravenous patient-controlled analgesia (PCA) morphine (1.0 mg bolus with 5-minute lockout) was available for 9.5 hours in the postoperative period. Visual analog pain scores were recorded during the postoperative period, and hourly morphine consumption data were retrieved from the PCA apparatus. Fitness for discharge was evaluated by the postanesthesia care unit nurse using standardized discharge criteria.Visual analog pain scores were higher in group 2 patients until 3.5 hours after surgery. Patients in the saline group had higher intravenous morphine consumption during all 1-hour postoperative intervals, although the differences between groups were statistically significant only until 4.5 hours after the operation. Total intravenous morphine consumption during the first 9.5 hours after surgery in group 1 was 16.9+/-11.9 mg versus 31.1+/-18.0 mg in group 2 (P.05). Postoperative nausea and vomiting occurred with equal frequency (87%) in both study groups, and there was no difference between groups in time to achieve fitness for discharge, i.e., a postanesthesia discharge score ofor = 9.Preoperative tumescent infiltration with lidocaine results in reduced pain and lower postoperative opioid requirements in the initial hours after reduction mammoplasty. |
| Databáze: | OpenAIRE |
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