Abstract

Background: Although not completely painless, breast-conserving surgery is considerably less painful than modified radical mastectomy. Local anesthetics are speculated to reduce postoperative pain when placed at the surgical site. Thus, we conducted a systematic review of randomized controlled trials to evaluate the efficacy of bupivacaine or ropivacaine analgesia for pain relief in breast cancer surgery. Methods: PubMed, Embase, the Cochrane Library, Scopus, and the ClinicalTrials.gov registry were searched for studies published up to July 2015. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size by using random effects models. Pain was assessed using a visual analog scale at 1, 2, 12, and 24 h postoperatively. The secondary outcomes included complications and analgesic consumption. Results: We reviewed 13 trials with 1150 patients. We found no difference in postoperative pain reduction at 1, 12, and 24 h after breast cancer surgery between the experimental and control groups. The severity of pain was significantly reduced in the experimental group (weighted mean difference -0.19; 95% confidence interval: -0.39-0.00) at 2 h postoperatively. Moreover, postoperative analgesic consumption did not differ significantly between the groups. No major drug-related complication was observed in any study. Conclusion: Administration of the local anesthetics bupivacaine or ropivacaine during breast cancer surgery decreased pain significantly at only 2 h but did not reduce pain at 12, and 24 h postoperatively.

Original languageEnglish
Article number2119
Pages (from-to)79-85
Number of pages7
JournalInternational Journal of Surgery
Volume22
DOIs
Publication statusPublished - Oct 1 2015

Fingerprint

Bupivacaine
Analgesia
Meta-Analysis
Randomized Controlled Trials
Breast Neoplasms
Pain
Wounds and Injuries
Postoperative Pain
Local Anesthetics
Analgesics
Modified Radical Mastectomy
Segmental Mastectomy
Visual Analog Scale
PubMed
Libraries
Registries
ropivacaine
Confidence Intervals
Control Groups
Pharmaceutical Preparations

Keywords

  • Breast cancer
  • Bupivacaine
  • Local anesthesia
  • Meta-analysis
  • Postoperative pain
  • Ropivacaine
  • Wound infiltration

ASJC Scopus subject areas

  • Surgery

Cite this

@article{c556d7ec8cf04e1aa0adbdbb45fad072,
title = "Effect of wound infiltration with ropivacaine or bupivacaine analgesia in breast cancer surgery: A meta-analysis of randomized controlled trials",
abstract = "Background: Although not completely painless, breast-conserving surgery is considerably less painful than modified radical mastectomy. Local anesthetics are speculated to reduce postoperative pain when placed at the surgical site. Thus, we conducted a systematic review of randomized controlled trials to evaluate the efficacy of bupivacaine or ropivacaine analgesia for pain relief in breast cancer surgery. Methods: PubMed, Embase, the Cochrane Library, Scopus, and the ClinicalTrials.gov registry were searched for studies published up to July 2015. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size by using random effects models. Pain was assessed using a visual analog scale at 1, 2, 12, and 24 h postoperatively. The secondary outcomes included complications and analgesic consumption. Results: We reviewed 13 trials with 1150 patients. We found no difference in postoperative pain reduction at 1, 12, and 24 h after breast cancer surgery between the experimental and control groups. The severity of pain was significantly reduced in the experimental group (weighted mean difference -0.19; 95{\%} confidence interval: -0.39-0.00) at 2 h postoperatively. Moreover, postoperative analgesic consumption did not differ significantly between the groups. No major drug-related complication was observed in any study. Conclusion: Administration of the local anesthetics bupivacaine or ropivacaine during breast cancer surgery decreased pain significantly at only 2 h but did not reduce pain at 12, and 24 h postoperatively.",
keywords = "Breast cancer, Bupivacaine, Local anesthesia, Meta-analysis, Postoperative pain, Ropivacaine, Wound infiltration",
author = "Tam, {Ka Wai} and Chen, {Shin Yan} and Huang, {Tsai Wei} and Lin, {Chao Chun} and Chih-Ming Su and Li, {Ching Li} and Ho, {Yuan Soon} and Wang, {Wan Yu} and Wu, {Chih Hsiung}",
year = "2015",
month = "10",
day = "1",
doi = "10.1016/j.ijsu.2015.07.715",
language = "English",
volume = "22",
pages = "79--85",
journal = "International Journal of Surgery",
issn = "1743-9191",
publisher = "Elsevier Science Publishers B.V.",

}

TY - JOUR

T1 - Effect of wound infiltration with ropivacaine or bupivacaine analgesia in breast cancer surgery

T2 - A meta-analysis of randomized controlled trials

AU - Tam, Ka Wai

AU - Chen, Shin Yan

AU - Huang, Tsai Wei

AU - Lin, Chao Chun

AU - Su, Chih-Ming

AU - Li, Ching Li

AU - Ho, Yuan Soon

AU - Wang, Wan Yu

AU - Wu, Chih Hsiung

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background: Although not completely painless, breast-conserving surgery is considerably less painful than modified radical mastectomy. Local anesthetics are speculated to reduce postoperative pain when placed at the surgical site. Thus, we conducted a systematic review of randomized controlled trials to evaluate the efficacy of bupivacaine or ropivacaine analgesia for pain relief in breast cancer surgery. Methods: PubMed, Embase, the Cochrane Library, Scopus, and the ClinicalTrials.gov registry were searched for studies published up to July 2015. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size by using random effects models. Pain was assessed using a visual analog scale at 1, 2, 12, and 24 h postoperatively. The secondary outcomes included complications and analgesic consumption. Results: We reviewed 13 trials with 1150 patients. We found no difference in postoperative pain reduction at 1, 12, and 24 h after breast cancer surgery between the experimental and control groups. The severity of pain was significantly reduced in the experimental group (weighted mean difference -0.19; 95% confidence interval: -0.39-0.00) at 2 h postoperatively. Moreover, postoperative analgesic consumption did not differ significantly between the groups. No major drug-related complication was observed in any study. Conclusion: Administration of the local anesthetics bupivacaine or ropivacaine during breast cancer surgery decreased pain significantly at only 2 h but did not reduce pain at 12, and 24 h postoperatively.

AB - Background: Although not completely painless, breast-conserving surgery is considerably less painful than modified radical mastectomy. Local anesthetics are speculated to reduce postoperative pain when placed at the surgical site. Thus, we conducted a systematic review of randomized controlled trials to evaluate the efficacy of bupivacaine or ropivacaine analgesia for pain relief in breast cancer surgery. Methods: PubMed, Embase, the Cochrane Library, Scopus, and the ClinicalTrials.gov registry were searched for studies published up to July 2015. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size by using random effects models. Pain was assessed using a visual analog scale at 1, 2, 12, and 24 h postoperatively. The secondary outcomes included complications and analgesic consumption. Results: We reviewed 13 trials with 1150 patients. We found no difference in postoperative pain reduction at 1, 12, and 24 h after breast cancer surgery between the experimental and control groups. The severity of pain was significantly reduced in the experimental group (weighted mean difference -0.19; 95% confidence interval: -0.39-0.00) at 2 h postoperatively. Moreover, postoperative analgesic consumption did not differ significantly between the groups. No major drug-related complication was observed in any study. Conclusion: Administration of the local anesthetics bupivacaine or ropivacaine during breast cancer surgery decreased pain significantly at only 2 h but did not reduce pain at 12, and 24 h postoperatively.

KW - Breast cancer

KW - Bupivacaine

KW - Local anesthesia

KW - Meta-analysis

KW - Postoperative pain

KW - Ropivacaine

KW - Wound infiltration

UR - http://www.scopus.com/inward/record.url?scp=84943552772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84943552772&partnerID=8YFLogxK

U2 - 10.1016/j.ijsu.2015.07.715

DO - 10.1016/j.ijsu.2015.07.715

M3 - Article

VL - 22

SP - 79

EP - 85

JO - International Journal of Surgery

JF - International Journal of Surgery

SN - 1743-9191

M1 - 2119

ER -