Back
 ABCR  Vol.7 No.4 , October 2018
Comparative Study between Lidocaine 2% and Dexamethasone Local Wound Infiltration Effect on Postoperative Pain Post Mastectomy: A Randomized Controlled Study
Abstract: Objective: To compare the efficacy and safety of Lidocaine 2% versus Dexamethasone injected locally in mastectomy wound as pain relieving agents. Materials & Methods: A randomized single-blinded study in which 50 patients candidate for Mastectomy were included. Participants were equally randomized into two groups; Group A, in which patients received 10 ml Lidocaine 2% and Group B, in which patients received 16 mL Dexamethasone. In both groups, the drugs were given via local infiltration in the subcutaneous layer of the Mastectomy wound immediately after skin closure. Pain control was assessed post-operatively in the first 24 hours using the visual analogue scale (VAS) in addition the need for additional analgesia was recorded. Results: There was a statistically significant lower VAS score in group A (Lidocaine group) when compared to those in group B (Dexamethasone group) 1 h, 6 h, 12 h postoperatively with no significance 24 h postoperatively (36% vs 64% 1 h, 28% vs 64% 6 h, 30% vs 72% 12 h and, 80% vs 60% 24 h). This statistical significance was evident throughout the post-operative hours (1 h, 6 h, 12 h). Though local Lidocaine caused marked improvement of pain in bigger number of patients in group A than group B, yet it showed no statistical significance 24 h post-mastectomy. Furthermore, the number of participants that needed additional doses of analgesia lower in group A (48% vs 56%) in comparison to group B, but still showed no statistical significance. Conclusion: Local injection of Lidocaine 2% in Mastectomy wounds, has an upper hand in reducing the post-operative pain and showed a lesser need for post-operative analgesia when compared to local Dexamethasone injection.
Cite this paper: Soliman, H. (2018) Comparative Study between Lidocaine 2% and Dexamethasone Local Wound Infiltration Effect on Postoperative Pain Post Mastectomy: A Randomized Controlled Study. Advances in Breast Cancer Research, 7, 243-249. doi: 10.4236/abcr.2018.74015.
References

[1]   Trescot, A.M., Datta, S., Lee, M. and Hansen, H. (2008) Opioid Pharmacology. Pain Physician, 11, S133-S153.

[2]   Schnabel, A., Reichl, S.U., Kranke, P., Pogatzki-Zahn, E.M. and Zahn, P.K. (2010) Efficacy and Safety of Paravertebral Blocks in Breast Surgery: A Meta-Analysis of Randomized Controlled Trials. British Journal of Anaesthesia, 105, 842-852.
https://doi.org/10.1093/bja/aeq265

[3]   Naja, Z. and Lonnqvist, P.A. (2001) Somatic Paravertebral Nerve Blockade. Incidence of Failed Block and Complications. Anaesthesia, 56, 1184-1188.
https://doi.org/10.1046/j.1365-2044.2001.02084-2.x

[4]   Koppert, W., Weigand, M., Neumann, F., et al. (2004) Perioperative Intravenous Lidocaine Has Preventive Effects on Postoperative Pain and Morphine Consumption after Major Abdominal Surgery. Anesthesia & Analgesia, 98, 1050-1055.
https://doi.org/10.1213/01.ANE.0000104582.71710.EE

[5]   Khalaj, A.R., Miri, S.R., Po Lashkari, M. and Mohammadi, A. (2013) Prophylactic Antiemetic Effect of Dexamethazone and Metocloporamide on Nausea and Vomiting Induced by Laparoscopic Cholecystectomy: A Randomized Double Blind, Placebo Controlled Trial. Journal of Minimally Invasive Surgical Sciences, 2, 18-22.

[6]   Soleimanpour, H., Hassanzadeh, K., Vaezi, H., Golzari, S.E., et al. (2012) Effectiveness of Intravenous Lidocaine versus Intravenous Morphine for Patients with Renal Colic in the Emergency Department. BNC Urology, 12, 13.

[7]   MacGregor, P.R., Thorner, R.E. and Wright, D.M. (1980) Lidocaine Inhibits Granulocyte Adherence and Prevents Granulocyte Delivery to Inflammatory Sites. Blood, 56, 203-209.

[8]   Mansour, M.G., Rahman, S. and Jafarabai, M. (2015) local Lidocaine 2% in Postoperative Pain Management in Caserean Delivery. Journal of Family and Reproductive Health, 9, 19-21.

[9]   Sekhavat, L. and Behdad, S. (2011) Preoperative Analgesia with Local Lidocaine for Cesarean Delivery Pain Relief. The Journal of Maternal-Fetal and Neonatal Medicine, 24, 891-893.
https://doi.org/10.3109/14767058.2010.537410

[10]   Walash, D.A., Mapp, P.I. and Kelly, S. (2015) Calcitonin Gene-Related Peptide in the Joint: Contributions to Pain and Inflammation. British Journal of Clinical Pharmacology, 80, 965-978.

[11]   Bisgaard, T., Klarskov, B., Kehlet, H. and Rosenberg, J. (2003) Preoperative Dexamethasone Improves Surgical Outcome after Laparoscopic Cholecystectomy: A Randomized Double-Blind Placebo-Controlled Trial. Annals of Surgery, 238, 651-660.
https://doi.org/10.1097/01.sla.0000094390.82352.cb

[12]   Grigoras, A., Lee, P., Sattar, F. and Shorten, G. (2012) Perioperative Intravenous Lidocaine Decreases the Incidence of Persistent Pain after Breast Surgery. The Clinical Journal of Pain, 28, 567-572.

[13]   Chiu, M., Bryson, G.L., Lui, A., Watters, J.M., Taljaard, M. and Nathan, H.J. (2014) Reducing Persistent Postoperative Pain and Disability 1 Year after Breast Cancer Surgery: A Randomized, Controlled Trial Comparing Thoracic Paravertebral Block to Local Anaesthesia. Annals of Surgical Oncology, 21, 795-801.
https://doi.org/10.1245/s10434-013-3334-6

 
 
Top