A COMPARATIVE STUDY OF POST OPERATIVE ANALGESIA OF BUPIVACAINE OR ROPIVACAINE INSTILLED THROUGH SURGICAL DRAIN IN MODIFIED RADICAL MASTECTOMY
Dr. Rijesh R. and *Dr Bindu M.
According to GLOBOCAN fact sheet which was published in 2014 [international agency for research on cancer, WHO] incidence of breast cancer in world was approximately 1.38 million (23% of all neoplasms) on 2012. Modified radical mastectomy is the most popular surgical treatment modality for carcinoma breast. Postoperative pain has been severe in MRM cases and demands for pain relief are high. Various strategies like non-steroidal anti-inflammatory drugs, opioids, peripheral nerve blocks, wound infiltration with local anaesthetics, offered significant improvement in this aspect. We wanted to compare the duration of analgesia of Bupivacaine and Ropivacaine instilled through surgical drain site in patients undergoing modifiedradical mastectomy at government Medical College Thrissur during the period January 2016 – December 2016. Methods: In this observational study 130 patients aged 18–65 years were divided into two groups. All patients were administered general anaesthesia. At the end of the surgical procedure, axillary and chest wall drains were placed before closure. Group A received 0.25% of 30 ml Ropivacaine and Group B 0.25 % of 30 ml Bupivacaine and the drain will be clamped for ten min. Post extubationpain was evaluated using VAS and subsequently every eight hourly upto 24 hours. Rescue analgesia with injection tramadol1mg/kg IM will be administered if the patients complain of pain at any point of time. Statistical analysis was using IBM SPSS version 20.0 Results: There exists a marginal significance in the duration of analgesia. The meanduration of analgesia in Ropivacaine group was10.323 and Bupivacaine group was 9.600. Conclusion: Wound instillation with Ropivacaine is a sensible alternative than Bupivacaine with respect to post operative analgesia and side effects.[Full Text Article]