Sreenivasa Rao S1, Obulapathy D2
AIMS: This study was conducted to evaluate and compare the efficacy of two sequential sessions of tumescent analgesia in modified radical mastectomy patients for immediate postoperative pain relief.
MATERIALS AND METHODS: In this prospective randomized controlled study 100 patients treated by MRM for operable breast carcinoma in S.V.R.R.G.G. Hospital and Sri Venkateswara Medical College, Tirupati, were included in the study. They were evaluated for two consecutive sessions of tumescent analgesia. Session I involved infiltration of 20 cc of 0.25% bupivacaine subcutaneously in to the incisional area plus wound instillation of 100 CC of 0.4% xylocaine with adrenaline with 1 mg of butorphanol through the axillary drains. Pain was assessed every 30 minutes by using visual analogue scale (VAS). Pain of VAS-3 was taken as cut off point and session II of wound instillation (100 CC of 0.4% xylocaine with adrenaline with 1 mg of butorphanol through the axillary drains) alone was executed. The efficacy of these two methods of tumescent analgesia was assessed and compared. Statistical analysis was performed using SPSS version.
RESULTS: Session I tumescent analgesia conferred 9 to 10 hours of pain relief and session II for 7 to 8 hours.
CONCLUSION: Incisional infiltration of bupivacaine showed cumulative effect and imporved the quality and duration of analgesia in MRM patients in the immediate postoperative period. Tumescent analgesia is a simple and effective means of providing good postoperative pain relief without any major side-effects.
