Assessment of Postoperative Analgesia in Modified Radical Mastectomy Following Instillation of Bupivacaine through Surgical Drains.

Background: Globally, breast cancer is a significant public health concern in women. Modified radical mastectomy (MRM) is a commonly used surgical treatment. Postmastectomy pain is a serious concern because, if left untreated, can have psychological effects, resulting in postoperative complications. This observational study aimed to assess the effectiveness of bupivacaine for postoperative analgesia administered using surgical drains after MRM.

Methods: Sixty female patients who underwent MRM were included in the study. Patients in Group A received 40 mL of 0.25% bupivacaine, 20 mL through each drain placed in the axilla and chest wall below flap. Patients in Group B received standard postoperative pain management. The postoperative visual analog scale (VAS) score was evaluated every 4 h for 24 h. When the patient's VAS score was higher than 3 at any point during the treatment, they received slow intravenous injections of 1 mg/kg tramadol. The period of analgesia was measured from the point when the analgesic was introduced until the onset of the first rescue analgesia. Both the total number of times the medication was administered, and the total number of analgesics needed were recorded.

Results: The median total dose of rescue analgesia given to Group B (median = 113.0 mg tramadol) was higher compared to Group A (median = 47.5 mg tramadol) with P = 0.001.

Conclusions: Patients who received bupivacaine through surgical drains experienced longer and more effective analgesia. It is an easy, economical way to get good analgesia following surgery with minimal adverse reactions.