Effect of Bupivacaine (Marcaine) Injection into the Breast Pocket on Postoperative Pain in Patients Undergoing Augmentation Mammoplasty

Abstract

Introduction: Bupivacaine (Marcaine) is known to be an effective local anesthetic agent. The question arises as to whether there is a role for placing this anesthetic into the breast implant pocket in breast augmentation surgery to achieve a greater degree of postoperative pain relief. The purpose of this study was to test the effectiveness of locally administered intraoperative bupivacaine into the breast pocket during augmentation mammoplasty. Materials and Methods: The study group consisted of 62 consecutive female breast augmentation patients ranging in age from 17 to 58 years. The clinical trial took place between December 2003 and March 2005 and was conducted in a prospective, randomized, double-blinded fashion using patient opinion on a postoperative pain scale rated from 1–10. Bupivacaine (150 mg) was placed into the implant pocket of the random test side after implant insertion, while no anesthetic was placed for the control group. Data were collected at time points of 0, 1, 3, and 6 hours after surgery as well as 1 week following surgery. The 0-hour data point was collected as soon as the patient was alert at the end of the procedure. Data were analyzed using paired t tests with the Bonferroni correction applied. Results: Based on the 10-point pain scale, the only statistically relevant difference occurred at the 1-hour postoperative time point, at which the mean pain level for the bupivacaine injected side was 3.0, while the mean pain level for the noninjected side was 4.2 with a P value of .01. There were no dropouts in the study. No hematomas or complications requiring reoperation were noted. Conclusion: The use of locally injected bupivacaine into the breast pocket during breast augmentation may be beneficial in alleviating some of the postoperative pain associated with augmentation mammoplasty.