Application of a locally placed anesthesia catheter for reduction of postoperative pain after mastectomy for breast cancer.

Objective: Postoperative pain management is important, especially in cancer patients. We describe our experience with the application of a locally placed continuous local anesthetic-releasing catheter for wound pain reduction after mastectomy for breast cancer.

Materials and methods: Retrospective evaluation of a continuous series of 41 patients at Fayette Medical Center, AL, USA, receiving an anesthetic-releasing catheter from January 2000 until June 2004. We used a pain management system with 270 ml volume of 0.25% Sensorcaine (bupivacaine and epinephrine) and a release rate through dual catheter ends of 2 ml/h each, lasting for approx. 67.5 h post op.

Results: 41 patients, age 67.0 (42-84) years, height 164.5 (152.4-177.8) cm, weight 71.1 (45.4-129.4) kg were treated after mastectomies (n=43; two bilateral) for breast cancer (n=30) and carcinoma in situ (CIS) (n= 11) with a local anesthetic wound catheter (n=43). The following procedures were performed: 31 modified radical mastectomies, 10 simple mastectomies and 2 simple mastectomies with sentinel lymph nodes. Intraoperative application of such a catheter system took less than 3 minutes. No intra- or postoperative complication or infection occurred within a follow up time of 30.3 months (0.2-52.4).

Conclusion: Application of this temporary anesthesia catheter after mastectomy is easy and safe and reduces postoperative pain.