Effect of wound infiltration with ropivacaine or bupivacaine analgesia in breast cancer surgery: A meta-analysis of randomized controlled trials

Ka Wai Tam, Shin Yan Chen, Tsai Wei Huang, Chao Chun Lin, Chih-Ming Su, Ching Li Li, Yuan Soon Ho, Wan Yu Wang, Chih Hsiung Wu

研究成果: 雜誌貢獻文章

16 引文 (Scopus)

摘要

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.
原文英語
文章編號2119
頁(從 - 到)79-85
頁數7
期刊International Journal of Surgery
22
DOIs
出版狀態已發佈 - 十月 1 2015

指紋

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

ASJC Scopus subject areas

  • Surgery

引用此文

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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",
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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

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