<< Back to the abstract archive
Bupivacaine versus Depofoam Bupivacaine in Breast Augmentation: a prospective randomized double-blinded study
Meghan Nadeau, MD; Anju Saraswat, MD; Alexander Vasko; Susan Vasko, MD
The Ohio State University
2013-03-15
Presenter: Meghan Nadeau, MD
Affidavit:
80% original work of the resident
Director Name: Gregory Pearson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Breast augmentation is the most common cosmetic surgery. Several show improved post-operative pain control with instillation of local anesthetic into the implant pocket. There is a newly available long acting preparation of bupivacaine, DepoFoam Bupivacaine (DFB).
Objectives: The authors investigate the efficacy of DFB compared to standard bupivacaine for post-operative pain control after breast augmentation. Given the difference in cost between the products ($285/20ml DFB versus $1.15 /30 ml bupivacaine), we wanted to establish whether or not there is a perceivable benefit to the longer acting product.
Methods: In this prospective randomized double-blinded study, eleven patients undergoing cosmetic primary subpectoral breast augmentation were telephoned and a brief pain inventory administered every 12 hours up to 72 hours postoperatively. The right and left breast of each patient was randomized to receive either DFB or bupivacaine with epinephrine in the implant pocket before closure. A p value of less than 0.05 was considered significant.
Results: Statistical analysis showed significant difference in pain scores between the right and left breast in the categories of worst, least, and average pain at 48 and 60 hours. The average difference in pain score on a scale of 1-10 was 0.8-1.27.
Conclusions: Patients report a statistically significant lower pain score in the breast with DFB at 48 and 60 hours post-operatively. Although there is a difference, the highest average difference was 1.27. Therefore, although there is a statistical difference this may not translate to an appreciable clinical benefit that justifies a significantly more expensive local anesthetic.
