A review of pain pumps in plastic surgery

Chandran, Geethan; Lalonde, Donald H.

doi:10.4172/plastic-surgery.1000637

Cited by 10 publications

(6 citation statements)

References 18 publications

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“…Incorporation of multiple safety steps may improve detection of intravascular injection or impending toxicity. Although it appears that anesthetic infusion pumps are safe in aesthetic and reconstructive surgery, 27 a high rate of pump malfunction was observed in 1 series. 28 Pump malfunction aside, applying safety steps such as those used for peripheral nerve blockade may reduce risk in surgeon-initiated continuous anesthetic infusion.…”

Section: Prevention Of Toxicity: Safety Stepsmentioning

confidence: 99%

Local Anesthetic Systemic Toxicity

Dickerson¹,

Apfelbaum²

2014

Aesthetic Surgery Journal

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Section: Prevention Of Toxicity: Safety Stepsmentioning

confidence: 99%

Local Anesthetic Systemic Toxicity

Dickerson¹,

Apfelbaum²

2014

Aesthetic Surgery Journal

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“…32 One of the downsides of local blocks is their short duration of action. 33 To address this issue, strategies such as delivery of local anesthetic by means of continuous infusion catheters 34 and biological carriers have been developed. Liposomal bupivacaine is one such drug that was developed to address this issue.…”

Section: Ementioning

confidence: 99%

Comparison of Liposomal Bupivacaine to a Local Analgesic Cocktail for Transversus Abdominis Plane Blocks in Abdominally Based Microvascular Breast Reconstruction

Lombana

Falola

Zolfaghari

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Transversus abdominis plane blocks can improve pain control and decrease opioid use within an enhanced recovery after surgery (ERAS) protocol in patients undergoing abdominally based autologous breast reconstruction. The authors have transitioned to using a local analgesic cocktail for transversus abdominis plane blocks. The purpose of this study was to compare postoperative opioid use in patients who received the blocks. Methods: Patients who underwent abdominally based autologous breast reconstruction between November of 2015 and December of 2019 were retrospectively reviewed. The study group received bupivacaine, ketorolac, dexmedetomidine, and dexamethasone; the control group received liposomal bupivacaine with or without bupivacaine, ketorolac, or dexmedetomidine, as a transversus abdominis plane block. The primary outcome of interest was postoperative opioid use and pain scores. Results: One hundred four women met inclusion criteria: 36 in group A (before ERAS, before transversus abdominis plane block), 38 in group B (ERAS, transversus abdominis plane block with liposomal bupivacaine), and 30 in group C (ERAS, transversus abdominis plane block with local anesthetic cocktail). Total daily oral morphine equivalent consumption (group A, 633; group B, 240; group C, 135; p < 0.0001) and average daily oral morphine equivalent consumption (group A, 137; group B, 56; group C, 29; p < 0.0001) were significantly less for group C in the inpatient phase. Patients in group C were prescribed significantly fewer outpatient oral morphine equivalents (group A, 79; group B, 74; group C, 52; p = 0.01). Conclusions: Transversus abdominis plane blocks are a significant component of an ERAS protocol for abdominally based breast reconstruction. Liposomal bupivacaine is a popular option for transversus abdominis plane blocks. The authors’ results demonstrate that a local anesthetic cocktail, composed of economical and readily available medications, can provide excellent patient pain control and decrease postoperative opioid use. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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“…Various locoregional anesthetic techniques are also used for breast surgeries. These include local wound infiltration, 30 tumescent anesthesia, 31 regional anesthetic techniques, such as pectoralis nerve (Pecs) blocks type 1 and 2, 32,33 serratus plane block (SPB), 34 and parasternal block (PSB), 35 pain pump, 36,37 and intravenous regional block. 38,39 Locoregional anaesthesia provides effective anesthesia and analgesia in the perioperative setting.…”

Section: Breast Reductionmentioning

confidence: 99%

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction.

Sansone

Giaccari

Faenza

et al. 2020

Preprint

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Background: Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently used anaesthetic technique. Various locoregional anesthetic techniques are also used for breast surgeries. A systematic review of the use of locoregional anesthesia for postoperative pain in breast surgery is needed to clarify its role in pain management.Objectives: To systematically review literature to establish the efficacy and the safety of locoregional anesthesia used in the treatment of pain after breast surgery.Methods: Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in Mars 2020 for studies examining locoregional anesthesia for management of pain in adults after breast surgery. The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively.Results: Nineteen studies evaluating locoregional anesthesia were included: 1058 patients underwent lumpectomy/mastectomy, 142 breast augmentation and 79 breast reduction. Locoregional anesthesia provides effective anesthesia and analgesia in the perioperative setting. After mastectomy, the use of locoregional anesthesia techniques seems to reduce pain, especially in the first hour after the end of the surgery. Other potentially beneficial effects of locoregional anesthesia emerged from our review include decreased need for opioids, decreased postoperative nausea and vomiting, fewer complications and increased patient satisfaction. All this improves postoperative recovery and shortens hospitalization stay.Conclusion: The results of this study support the technique of locoregional anesthesia for breast surgery.

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A review of pain pumps in plastic surgery

Cited by 10 publications

References 18 publications

Local Anesthetic Systemic Toxicity

Local Anesthetic Systemic Toxicity

Comparison of Liposomal Bupivacaine to a Local Analgesic Cocktail for Transversus Abdominis Plane Blocks in Abdominally Based Microvascular Breast Reconstruction

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction.

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