• Denis S Valente.
• Porto Alegre, Brazil From the Division of Plastic Surgery and Reconstructive Microsurgery, Santa Casa Hospital; and the Division of Plastic Surgery, Mãe de Deus Health System.
• Plast. Reconstr. Surg. 2014 Oct 1;134(4):581-6.

BackgroundPreincisional analgesia is an antinociceptive treatment that prevents altered central excitability from high-intensity noxious stimuli. To determine the analgesic efficacy of preoperative infiltration with bupivacaine for reduction mammaplasty, a randomized, double-blind, placebo-controlled trial was designed.MethodsWomen with mammary hypertrophy were allocated randomly to one of two study groups. Patients in group I received preincision infiltration with bupivacaine into each breast after general anesthesia. Group II patients received similar injections of saline injection alone after general anesthesia.ResultsVisual analogue pain score, verbal pain score, and short-form McGill Pain Questionnaire scores were higher in group II patients until 22 hours after surgery (p < 0.008). Patients in the saline group had higher intravenous meperidine consumption for 22 hours postoperatively and solicited opioids before the patients in the bupivacaine group (p < 0.001). The difference between groups was statistically significant.ConclusionPreincisional infiltration with bupivacaine results in reduced pain and lower postoperative opioid requirements in the early postoperative phase of pain following breast reduction.Clinical Question/Level Of EvidenceTherapeutic, I.

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