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The analgesic effect of wound infiltration with local anaesthetics after breast surgery: a qualitative systematic review
Author(s) -
BYAGER N.,
HANSEN M. S.,
MATHIESEN O.,
DAHL J. B.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12287
Subject(s) - medicine , analgesic , breast reduction , breast surgery , mastectomy , randomized controlled trial , clinical trial , anesthesia , surgery , opioid , mammaplasty , breast cancer , receptor , cancer
Background Wound infiltration with local anaesthetics is commonly used during breast surgery in an attempt to reduce post‐operative pain and opioid consumption. The aim of this review was to evaluate the effect of wound infiltration with local anaesthetics compared with a control group on post‐operative pain after breast surgery. Methods A systematic review was performed by searching P ub M ed, G oogle S cholar, the C ochrane database and E mbase for randomised, blinded, controlled trials of wound infiltration with local anaesthetics for post‐operative pain relief in female adults undergoing breast surgery. The analgesic effect was evaluated in a qualitative analysis by assessment of significant difference between groups ( P < 0.05) in pain scores and supplemental analgesic consumption. Results Ten trials including 699 patients were included in the final analysis. Three trials investigated mastectomy, four trials partial or segmental mastectomy, and three trials breast reduction, excision of benign lump and unspecified breast surgery, respectively. Six trials demonstrated a small and short‐lasting, but statistically significant reduction of post‐operative pain scores, and four trials observed a statistically significant reduction in post‐operative, supplemental opioid consumption that was, however, of limited clinical relevance. Conclusion Wound infiltration with local anaesthetics may have a modest analgesic effect in the first few hours after surgery. Pain after breast surgery is, however, generally mild to moderate, and other non‐invasive analgesic methods may be preferable in this surgical population.