Title: A Comparative Study of Wound Instillation with Different Concentration of Bupivacaine via Surgical Drain for Post-Operative Analgesia in Modified Radical Mastectomy

Authors: Dr Rajesh Kumar Meena, Dr Anita Pareek, Dr Kiwi Mantan, Dr Sangeeta Meena, Dr Priyanka Kumari

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i4.50

Abstract

Background & Aim: In this randomized, controlled , double-blind study of wound instillation to compare  with different concentration of bupivacaine via surgical drain in patient undergoing modified radical mastectomy would reduce the postoperative acute pain and would reduce amount of rescue analgesics used in postoperative period. Aim of the study is to evaluate the efficacy of bupivacaine for analgesia with different concentration and provide economical, safe and good analgesia.

Material and Method: Ninety patient undergoing elective modified radical mastectomy were randomized in to 3 groups. Following placing the surgical drain, Group A received no instillation. Group B and C received bupivacaine 0.125 % and 0.25% instillation via surgical drains. Pain was assessed using visual analog scale at fixed time interval and other side effects were noted for next 24 hrs. Statistical analysis was done by using SPSS version 21, INDOSTAT statistical analysis software.

Observations: No significant difference were seen in analgesic duration with higher concentration dosage of bupivacaine. The median pain level postoperatively were 4+.5hr and 6+5hr in group B and C. (p value <0.001)

Conclusion: Higher concentration of Bupivacaine doesn’t significantly improve the duration of pain control. Instead of potential dose related risks.

Keywords: wound instillation, Bupivacaine (0.125% & 0.25%), Visual analogue scale (VAS).

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Corresponding Author

Dr Rajesh Kumar Meena