Bupivacaine Versus Liposomal Bupivacaine For Breast Pain Management After Breast Recontruction

Prospective, Randomized, Blinded Comparison of Bupivacaine Versus Liposomal Bupivacaine For Breast Pain Management After Unilateral, Immediate Breast Reconstruction

The purpose of this study is to determine the most effective way to control post-operative breast pain for patients undergoing a unilateral, immediate breast reconstruction.

This is a randomized controlled study to compare the effectiveness of a breast nerve block performed with bupivacaine as compared to liposomal bupivacaine in providing postsurgical analgesia in patients undergoing unilateral abdominally-based breast reconstruction at time of mastectomy.

OBJECTIVES

1. Compare the amount of postoperative narcotic use in patients receiving a bupivacaine or liposomal bupivacaine pectoralis and serratus anterior nerve block. Compare these groups to a retrospective control cohort who received local anesthetic infusion but did not receive any nerve block.
2. Examine the incidence of narcotic-related side effects in the experimental groups by documenting incidents of nausea and vomiting, time to first ambulation, liquid and solid oral intake.
3. Survey patient satisfaction with pain management using a visual analog scale during their hospital stay.

Inclusion Criteria:

• Patients scheduled to have a unilateral, immediate breast reconstruction

Exclusion Criteria:

• Pregnant

• Concurrent or recent medical condition that could interfere with study participation including:

  • Hepatitis
  • Alcohol/substance abuse
  • Uncontrolled psychiatric disorders
  • Known allergy
  • Contraindication to amide-type local anesthetics, opioids, or propofol.

• Body weight of less than 50 kg

• Participated in another study involving an investigational medication within the prior 30 days

• Taking analgesics (i.e., nonsteroidal anti-inflammatory drugs, acetaminophen, or opioids), antidepressants, or glucocorticoids within the 3 days before surgery.