Özet:

Pain management is very important after all surgical admissions for patients and for medical practitioners. Pain reducing or painlessness is provide patient pleasure and confidence to surgeon. Cure could be obtained by local and/or systemic ways in operable breast cancers. The purpose of operation is provide tumorectomy and prevent to local recurrence in these patients. If the patient has not distant metastases operation could be provide cure. In this study we aimed to evaluate to effects of local Bupivacaine application on postoperative pain control with comparing the conventional pain management technique. Prospective, randomised, double blind, clinical study planned on 33 women (31-81 years old, mean age 48.5) who are divided into two groups. Modified radical mastectomy and level l and ll axillary lymphatic dissection are performed to all patients. Peroperative intracutaneous Bupivacaine injected along the incision borders to 17 patients and if it needed postoperative intramuscular metamizole applied (Bupivacaine group). 16 patients took only postoperative intramuscular metamizole (control group). Postoperative pain measured via “simple definite scor (SDS)” and “visual analogue scala (VAS)”. Tumours are at left breast in 15 (45 %), at right in 18 (55 %) patients. Histopathologic classification of cancers of patients are; invasive ductal carcinoma in 5 (15 %) patients, invasive lobular carcinoma in 1 (3 %) patients, musinous carcinoma in 1 (3 %) patients, and anaplastic carcinoma in 1 (3 %) patients. Level I and ll axillary lymph node dissections are provided mean 9,1 (range 2-21) node extraction. Evaluations of groups via SDS and VAS score systems are appeared statistically significant differences between the two groups (p<0.001). Pain sensations in postoperative 1, 6, 18th hours are compared with Mann-Whitney U test. Patients pain sensations are significantly low in postoperative 1, 6, 18th hours in Bupivacaine group, according to either SDS or VAS score systems (for SDS p<0.05, for VAS p<0.001). Peroperative local bupivacaine injection is an effective postoperative pain management technique for mastectomies.

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