Comparison of continuous local anesthetic and systemic pain treatment after axillary lymphadenectomy in breast carcinoma patients -A prospective randomized study

Abstract

Background. Acute pain after axillary lymphadenectomy is often related mainly to axillary surgery. The aim of the prospective randomized study was to find out if continuous wound infusion of local anesthetic reduces postoperative pain, consumption of opioids and the incidence of chronic pain compared to the standard intravenous piritramide analgesia after axillary lymphadenectomy in breast carcinoma patients.

Methods. Altogether 60 patients were enrolled in our study; half in wound infusion of local anesthetic and half in the standard (piritramide) group.

Results. In the recovery room and on the first day after surgical procedure, the wound infusion of local anesthetic group reported less acute and chronic pain, a lower consumption of piritramide and metoclopramide, but their alertness after the surgical procedure was higher compared to the standard group.

Key Words: breast carcinoma; pain treatment; wound infusion of local anesthetic; elastomeric pump

Conclusions. After axillary lymphadenectomy in breast carcinoma patients, wound infusion of local anesthetic reduces acute pain and enables reduced opioid consumption, resulting in less postoperative sedation and a reduced need for antiemetic drugs. After wound infusion of local anesthetic there is a statistical trend for reduction of chronic pain.