Bupivacaine for Breast Reconstruction-Associated Pain?

HealthDay News — For patients undergoing autologous breast reconstruction, the incidence of chronic postsurgical pain (CPSP) does not differ for patients receiving transversus abdominis plane (TAP) catheters delivering bupivacaine or saline bolus, according to a study published online December 20 in Pain Practice.1

Justin Oh, from the Toronto General Hospital, and colleagues conducted a prospective follow-up study to compare the incidence of CPSP after autologous breast reconstruction between patients who received postoperative intermittent TAP catheters with bupivacaine or saline boluses. Participants included 93 patients who underwent deep inferior epigastric artery perforator or muscle-sparing transverse rectus abdominis breast reconstruction and were randomly allocated to receive TAP catheters with bupivacaine or saline.

The researchers found that at 6 and 12 months after surgery, 24 and 23% of patients reported CPSP, respectively. Pain-related variables, including incidence of CPSP, did not differ between the groups. The likelihood of having CPSP was increased at 6 months, but not at 12 months, among patients who reported greater variability in pain scores at rest over the first 48 hours postoperatively.

“Neither postoperative use of bupivacaine vs saline in the TAP catheters, nor acute pain severity influenced the 6- or 12-month incidence of CPSP,” the authors write.

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  1. Oh J, Pagé GM, Zhong T, et al. Chronic Postsurgical Pain Outcomes in Breast Reconstruction Patients Receiving Perioperative Transversus Abdominis Plane Catheters at the Donor Site: A Prospective Cohort Follow-Up Study. Pain Pract. 2016. doi: 10.1111/papr.12550