DOI: 10.36347/sjams.2019.v07i03.047

Pages: 1097-1100

To study the efficacy of instillation of bupivacaine into the surgical drain for post-operative pain relief in modified radical mastectomy, after obtaining institutional ethical committee clearance and written informed consent from the patient for this randomized prospective controlled double blinded study, 50 female patients with carcinoma breast of ASA I & II between the age group of 35 -65 years posted for modified radical mastectomy were divided into two groups, Group (C) and Group(S). All patients were selected according to the inclusion and exclusion criteria. Post-operative ward nurse monitors and records the data. The investigator collected the data only. GROUP (S)-Receives 0.25% Bupivacaine 30 ml through the surgical drain after skin closure. GROUP (C)-Receives Normal saline 30 ml through the surgical drain. Preoperatively, all patients were educated about the reading of pain score with ten pointed visual analogue scale. General anesthesia was given to all the patients. End of the surgical procedure, two drains were placed by the surgeon. One was placed over the pectoralis muscle beneath the skin flap and one in the axilla. Skin is closed and 15ml of 0.25% Bupivacaine or Saline were instilled in each drain (total of 30ml) by the surgeon or by the assisting nurse. The drain was kept closed for half an hour. Patient was given reversal and extubated after satisfying recovery criteria. Patient was shifted to post anaesthesia care unit and the followings were monitored for 24 hours by the nurse who was blind in this study.(a) vital signs, (b) Time of onset of first analgesic dose requirement, (c) Number of analgesic dose required, (d) Any other additional analgesic required. Intramuscular injection Tramodol was given as rescue analgesia if patient complains of pain or VAS is more than 4. It was concluded that wound instillation with local anesthetics provides good analgesia for patients following the MRM procedure.