Marcaine: A Dependable Local Anesthetic for Breast Augmentation

Abstract

Background: Many investigators have evaluated the utility of local anesthetic use before, during, and after augmentation mammoplasty. Routes used include subcutaneous injections, intercostal nerve blocks, pump infusions, drain infusions, and “splashing” into the submuscular pocket. Although many of these techniques yield statistically significant results, they can add time to the operation and can cause additional complications. In particular, local anesthetic pump infusions add significant cost and require a foreign body to be in contact with the skin in a pocket with a sterile implant. We sought to find an affordable solution that would decrease postoperative recovery time, reduce narcotic requirements, and decrease pain in the early postoperative period without adding significant cost or risk to the procedure. Objective: To determine whether Marcaine placement into the breast pocket during breast augmentation actually improves patient pain in the early postoperative period, and to determine whether this therapy has any detrimental effects. Methods: This double-blind, randomized study was undertaken to compare the effects of placing 10 mL 0.25% Marcaine with epinephrine into 1 or both breast pockets of each patient undergoing bilateral breast augmentation. We sought to evaluate whether this therapy improved postoperative pain and to assess the safety of using Marcaine for this purpose. Results: A total of 26 patients voluntarily enrolled in and completed our study. Of these, 25 received Marcaine in 1 or both breast pockets. In all, 24 patients reported less pain on the Marcaine-infused side, and 1 believed that her pain was equal in the 2 breasts. Among 4 patients who received Marcaine in both pockets, no narcotics were required in the recovery suite. No negative reactions to Marcaine were reported in any patient, nor were any infections or hematomas noted. Conclusions: Placing 10 mL of 0.25% Marcaine with epinephrine into each breast pocket during breast augmentation is a safe and effective form of early postoperative analgesia.