ESRA Academy. Zielinski J. Sep 8, 2016; 138489; 0349 Topic: Incisional Techniques - Wound Infiltration
Assoc. Prof. Jacek Zielinski
Assoc. Prof. Jacek Zielinski

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Background and Aims:

The study was designed as prospective, placebo-controlled, clinical trial. We have tested a hypothesis that preventive analgesia with bupivacaine applied in the area of surgical incision in patients undergoing central quadrantectomy for breast surgery would reduce the following parameters: the amount of analgesics used during operative and post-operative period, post-operative acute pain and frequency chronic pain syndrome.


Participants were assigned into two groups: with bupivacaine applied in the area of surgical incision or with placebo. We assessed the intraoperative consumption of fentanyl, the postoperative consumption of morphine delivered using a PCA method and postoperative acute and chronic pain intensity according to VAS score. Ethics approval No NKEBN /466/2004.


72 women out of 80 consecutive cases qualified for central quadrantectomy were allocated to two groups: group A (bupivacaine) and group B (placebo). The final study group comprised 72 cases.  Between the groups statistically significant difference was observed with respect to: lower fentanyl consumption during surgery (p<0.05), lower morphine (delivered by means of a PCA) consumption between 4th-12th postoperative hour (p=0.04), significantly lower acute pain intensity assessed according to VAS score at 4th and 12th hour after surgery (p=0.05 and p=0.04 respectively) for the group A patients and chronic pain intensity (p<0.05).


Preventive analgesia application in the form of infiltration of the area of planned surgical incisions with bupivacaine in patients undergoing central quadrantectomy decreases limits the amount of fentanyl used during surgery, post-operative acute and chronic pain sensation. Additionally preventive analgesia reduces the demand for opiates in early hours after surgery.

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