The efficacy of continuous local anesthetic infiltration in breast surgery: Reduction mammaplasty and reconstruction
The efficacy of continuous local anesthetic infiltration in breast surgery: Reduction mammaplasty and reconstruction
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DOI：
10.1097/01.prs.0000163332.04220.bd
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发表时间：
2005-06-01
影响因子：
3.6
通讯作者：
Fine, NA
中科院分区：
文献类型：
--
作者：
Lu, L;Fine, NA
背景：乳房缩小术和组织扩张器乳房再造术后疼痛控制通常需要静脉麻醉止痛和住院治疗。局部和局部麻醉技术越来越受欢迎，因为它们减少了静脉止痛药物的使用，并且提供了类似的止痛效果，而没有全身副作用。方法：本研究观察了74例连续缩乳和74例组织扩张器乳房再造患者使用留置导管持续渗透局部麻醉剂(布比卡因)的情况。2003年2月之前进入研究的患者接受常规镇痛方法(每组39例)，而之后进入研究的患者接受输液泵治疗(每组35例)。结果：使用输液泵的缩乳术患者的住院次数明显少于未使用输液泵的患者(p<；0.01)。止痛泵组在恢复室的疼痛评分从0到10分，显著低于对照组(p<；0.01)，止痛药的累计用量也是如此(p<；0.01)。在并发症的数量或恶心或呕吐的发生率方面没有统计学上的显著差异。使用输液泵的组织扩张器重建患者的住院天数与未使用输液泵的患者没有显著差异；平均疼痛评分显著低于未使用输液泵的患者(p<；0.01)。接受输液泵的患者的止痛药累积用量显著低于未接受输液泵的患者(p<；0.01)。在并发症的数量或恶心或呕吐的发生率方面没有统计学上的显著差异。植入物旁留置导尿管的患者无组织扩张器感染。结论：局部麻醉剂的持续输液泵渗透是外科患者疼痛控制的又一种手段。
Background: Pain control after reduction mammaplasty and breast reconstruction with tissue expanders often requires intravenous narcotic analgesia and inpatient hospitalization. Regional and local anesthetic techniques are increasing in popularity because they decrease the use of intravenous analgesic medications and offer comparable pain relief without the systemic side effects.Methods: This study examined the use of indwelling catheters for the continuous infiltration of local anesthetic (bupivacaine) in 74 consecutive breast reduction and 74 consecutive tissue expander breast reconstruction patients. Patients entering the study before February of 2003 had conventional methods of analgesia (39 patients for each group), whereas those entering afterwards received the infusion pumps (35 patients for each group).Results: The number of hospital admissions among the breast reduction patients with infusion pumps was significantly less than that for those without pumps (p < 0.01). Pain, measured on a verbal response scale of 0 to 10, while in the recovery room was significantly less in the pain pump group than in the comparison group (p < 0.01), as were cumulative amounts of pain medications (p < 0.01). There were no statistically significant differences in the number of complications or in the rate of nausea or vomiting. The number of inpatient days among the tissue expander reconstruction patients with infusion pumps was not significantly different from that for those without pumps; the average pain score was significantly lower (p < 0.01). The cumulative amounts of pain medication in patients receiving the infusion pump were significantly lower than those in patients without the pumps (p < 0.01). There were no statistically significant differences in the number of complications or in the rate of nausea or vomiting. There were no tissue expander infections in patients with the indwelling catheters adjacent to the implant.Conclusions: The continuous infiltration of local anesthetic with an infusion pump represents another tool for pain management in surgical patients.