Pain Management in Augmentation Mammaplasty: A Randomized, Comparative Study of the Use of a Continuous Infusion Versus Self-Administration Intermittent Bolus of a Local Anesthetic

摘要: Abstract Background Indwelling catheters for pain control after augmentation mammaplasty appear to be safe and effective. However, little is known regarding the comparison of continuous flow intermittent bolus anesthetics. Objective A prospective, randomized study was developed compare these 2 systems. Methods Forty-one patients were divided into groups. All used On-Q (I-Flow Corp, Lake Forest, CA) infusion pump system (2 mL per hour) in 1 breast. Group consisted 20 who, opposite breast, permitted themselves with 0.25% bupivacaine HCl 1:400,000 epinephrine (Sensorcaine; Astra Zeneca, Wilmington, DE) as needed, every 6 hours a maximum doses. 21 who requested instill 10 4 (total instillations) regardless need (except during sleep). Results regard effectiveness patient preference both groups assessed. asked avoid any additional analgesics or narcotics 30 60 minutes self-administration order record an unbiased self-assessment response instillation local anesthesia. seen day surgery given on side before implant mobility exercises. In group 1, preferred infusion, 9 bolus, had no either undecided. Among this group, 24-hour scores similar. 2, 13 5 self-administration, 3 Pain lower On-Q. An unexpected finding that unilateral 41 (42%) noted bilateral reduction pain. By 3, 33 (80%) narcotics. There complications associated device. Conclusions After mammaplasty, indwelling using anesthesia needed are effective controlling postoperative Continuous maintains steady state without intervention. Self-administration allows have more active role if they low-cost alternative commercial pump. These conclusions supported by review literature our own experience than 380 consecutive patients.