Locally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients

Raman C. Mahabir, Brian D. Peterson, J. Scott Williamson, Stan M. Valnicek, David G. Williamson, William E. East

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

With recent developments in the field of analgesia, the question arises whether there is a role for placing local anesthetics, nonsteroidal anti-inflammatory drugs, or both into the breast implant pocket. The objective of this study was to test the effectiveness of locally administered intraoperative ketorolac and bupivacaine with epinephrine at reducing pain in the postoperative period. The study was a prospective, randomized, double-blind clinical trial. One hundred consecutive retropectoral breast augmentation patients were enrolled, and informed consent was obtained. A standard anesthetic protocol and surgical procedure were followed. Normal saline, ketorolac alone (30 mg), bupivacaine alone (150 mg), or ketorolac and bupivacaine (30 mg and 150 mg respectively) were placed into the implant pocket before implant insertion. All patients completed the study. The power of this study to detect a 20 percent difference with respect to the primary outcome was 0.90 and confidence intervals of 95 percent were used to determine significance. The primary outcome was pain as measured by the visual analogue pain scale. The secondary outcome was time spent in the recovery room. Intraoperative placement of ketorolac combined with bupivacaine reduced pain in the postoperative period. It did not appear that anesthesiologist, anesthesia time, surgeon, operating room time, difficulty of dissection, breast incision, or implant size had a significant effect on postoperative pain. There was a trend that the ketorolac and bupivacaine patients spent less time in the recovery room and used fewer analgesics postoperatively than the other patients. There were no hematomas requiring reoperation and no complications. Locally administered intraoperative ketorolac and bupivacaine with epinephrine significantly reduced pain in the postoperative period.

Original languageEnglish (US)
Pages (from-to)1910-1916
Number of pages7
JournalPlastic and Reconstructive Surgery
Volume114
Issue number7
DOIs
StatePublished - Dec 2004
Externally publishedYes

Fingerprint

Ketorolac
Bupivacaine
Postoperative Pain
Breast
Postoperative Period
Recovery Room
Pain
Epinephrine
Breast Implants
Pain Measurement
Operating Rooms
Local Anesthetics
Informed Consent
Reoperation
Hematoma
Analgesia
Analgesics
Anesthetics
Dissection
Anti-Inflammatory Agents

ASJC Scopus subject areas

  • Surgery

Cite this

Mahabir, R. C., Peterson, B. D., Williamson, J. S., Valnicek, S. M., Williamson, D. G., & East, W. E. (2004). Locally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients. Plastic and Reconstructive Surgery, 114(7), 1910-1916. https://doi.org/10.1097/01.PRS.0000142996.50331.2C

Locally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients. / Mahabir, Raman C.; Peterson, Brian D.; Williamson, J. Scott; Valnicek, Stan M.; Williamson, David G.; East, William E.

In: Plastic and Reconstructive Surgery, Vol. 114, No. 7, 12.2004, p. 1910-1916.

Research output: Contribution to journalArticle

Mahabir, Raman C. ; Peterson, Brian D. ; Williamson, J. Scott ; Valnicek, Stan M. ; Williamson, David G. ; East, William E. / Locally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients. In: Plastic and Reconstructive Surgery. 2004 ; Vol. 114, No. 7. pp. 1910-1916.
@article{24f89c71b85a43aeb5f4f61dbd6e42d4,
title = "Locally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients",
abstract = "With recent developments in the field of analgesia, the question arises whether there is a role for placing local anesthetics, nonsteroidal anti-inflammatory drugs, or both into the breast implant pocket. The objective of this study was to test the effectiveness of locally administered intraoperative ketorolac and bupivacaine with epinephrine at reducing pain in the postoperative period. The study was a prospective, randomized, double-blind clinical trial. One hundred consecutive retropectoral breast augmentation patients were enrolled, and informed consent was obtained. A standard anesthetic protocol and surgical procedure were followed. Normal saline, ketorolac alone (30 mg), bupivacaine alone (150 mg), or ketorolac and bupivacaine (30 mg and 150 mg respectively) were placed into the implant pocket before implant insertion. All patients completed the study. The power of this study to detect a 20 percent difference with respect to the primary outcome was 0.90 and confidence intervals of 95 percent were used to determine significance. The primary outcome was pain as measured by the visual analogue pain scale. The secondary outcome was time spent in the recovery room. Intraoperative placement of ketorolac combined with bupivacaine reduced pain in the postoperative period. It did not appear that anesthesiologist, anesthesia time, surgeon, operating room time, difficulty of dissection, breast incision, or implant size had a significant effect on postoperative pain. There was a trend that the ketorolac and bupivacaine patients spent less time in the recovery room and used fewer analgesics postoperatively than the other patients. There were no hematomas requiring reoperation and no complications. Locally administered intraoperative ketorolac and bupivacaine with epinephrine significantly reduced pain in the postoperative period.",
author = "Mahabir, {Raman C.} and Peterson, {Brian D.} and Williamson, {J. Scott} and Valnicek, {Stan M.} and Williamson, {David G.} and East, {William E.}",
year = "2004",
month = "12",
doi = "10.1097/01.PRS.0000142996.50331.2C",
language = "English (US)",
volume = "114",
pages = "1910--1916",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Locally administered ketorolac and bupivacaine for control of postoperative pain in breast augmentation patients

AU - Mahabir, Raman C.

AU - Peterson, Brian D.

AU - Williamson, J. Scott

AU - Valnicek, Stan M.

AU - Williamson, David G.

AU - East, William E.

PY - 2004/12

Y1 - 2004/12

N2 - With recent developments in the field of analgesia, the question arises whether there is a role for placing local anesthetics, nonsteroidal anti-inflammatory drugs, or both into the breast implant pocket. The objective of this study was to test the effectiveness of locally administered intraoperative ketorolac and bupivacaine with epinephrine at reducing pain in the postoperative period. The study was a prospective, randomized, double-blind clinical trial. One hundred consecutive retropectoral breast augmentation patients were enrolled, and informed consent was obtained. A standard anesthetic protocol and surgical procedure were followed. Normal saline, ketorolac alone (30 mg), bupivacaine alone (150 mg), or ketorolac and bupivacaine (30 mg and 150 mg respectively) were placed into the implant pocket before implant insertion. All patients completed the study. The power of this study to detect a 20 percent difference with respect to the primary outcome was 0.90 and confidence intervals of 95 percent were used to determine significance. The primary outcome was pain as measured by the visual analogue pain scale. The secondary outcome was time spent in the recovery room. Intraoperative placement of ketorolac combined with bupivacaine reduced pain in the postoperative period. It did not appear that anesthesiologist, anesthesia time, surgeon, operating room time, difficulty of dissection, breast incision, or implant size had a significant effect on postoperative pain. There was a trend that the ketorolac and bupivacaine patients spent less time in the recovery room and used fewer analgesics postoperatively than the other patients. There were no hematomas requiring reoperation and no complications. Locally administered intraoperative ketorolac and bupivacaine with epinephrine significantly reduced pain in the postoperative period.

AB - With recent developments in the field of analgesia, the question arises whether there is a role for placing local anesthetics, nonsteroidal anti-inflammatory drugs, or both into the breast implant pocket. The objective of this study was to test the effectiveness of locally administered intraoperative ketorolac and bupivacaine with epinephrine at reducing pain in the postoperative period. The study was a prospective, randomized, double-blind clinical trial. One hundred consecutive retropectoral breast augmentation patients were enrolled, and informed consent was obtained. A standard anesthetic protocol and surgical procedure were followed. Normal saline, ketorolac alone (30 mg), bupivacaine alone (150 mg), or ketorolac and bupivacaine (30 mg and 150 mg respectively) were placed into the implant pocket before implant insertion. All patients completed the study. The power of this study to detect a 20 percent difference with respect to the primary outcome was 0.90 and confidence intervals of 95 percent were used to determine significance. The primary outcome was pain as measured by the visual analogue pain scale. The secondary outcome was time spent in the recovery room. Intraoperative placement of ketorolac combined with bupivacaine reduced pain in the postoperative period. It did not appear that anesthesiologist, anesthesia time, surgeon, operating room time, difficulty of dissection, breast incision, or implant size had a significant effect on postoperative pain. There was a trend that the ketorolac and bupivacaine patients spent less time in the recovery room and used fewer analgesics postoperatively than the other patients. There were no hematomas requiring reoperation and no complications. Locally administered intraoperative ketorolac and bupivacaine with epinephrine significantly reduced pain in the postoperative period.

UR - http://www.scopus.com/inward/record.url?scp=14944364726&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=14944364726&partnerID=8YFLogxK

U2 - 10.1097/01.PRS.0000142996.50331.2C

DO - 10.1097/01.PRS.0000142996.50331.2C

M3 - Article

C2 - 15577367

AN - SCOPUS:14944364726

VL - 114

SP - 1910

EP - 1916

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 7

ER -