Comparison of Postoperative Pain between Infiltrative Local Anesthesia plus Paracetamol and Total IntravenousAnesthesia plus Paracetamol in Ambulatory Breast Surgery

Background: Acute postoperative pain is an important surgical side effect thatmay delay patient discharge in ambulatory operations; moreover, the strategiesused to alleviate pain may cause side effects that require longer hospitalization torecover. In this clinical trial, we compared two current anesthetic methods withspecial concerns about postoperative pain intensity beside other importantcomponents of ambulatory anesthesia.Methods: This clinical trial was conducted on two age-matched groups of 75members who underwent ambulatory breast surgery. Patients in the first group(GA) underwent general anesthesia with propofol plus remifentanil by employinga laryngealmask airway. In the second group (LA), the surgeon used infiltration of2% lidocaine in the breast tissue and midazolam was applied as premedication. Atthe end of surgery, paracetamol was administered to all patients in both groups. Thepain score was evaluated when the patients were fully awake using a numericalpain rating scale. Patients with severe pain received analgesia. The length ofpostanesthesia care unit (PACU) stay was recorded for each patient.Results: None of the patients in the LA group were satisfied because of theexperience of needle insertion into their breast tissue (P = 0.001). The patients inthe LA group experienced more pain in PACU requiring adjuvant analgesia (P =0.001). Patients in the LAgroup had longer PACUadmission (P= 0.001).Conclusions: Patients in the LA group had higher pain scores and weredissatisfied with the plan of their anesthesia. This may confirm the role ofpreemptive analgesia or the effect of emotional stress of breast tissue needling inwakeful patient.

Comparison of Postoperative Pain between Infiltrative Local Anesthesia plus Paracetamol and Total IntravenousAnesthesia plus Paracetamol in Ambulatory Breast Surgery Keywords:

Breast surgery , postoperative pain , ambulatory anesthesia