psd-502 and Breast-Neoplasms

Patients undergoing excision for breast lumps prefer general anesthesia or local anesthesia plus sedation, because of the fear of pain for local anesthesia alone. The aim of this study is to show the efficacy of an eutectic mixture of local anesthetic lignocaine and prilocaine (EMLA®) in these patients.. This study has been designed randomized, placebo-controlled. Forty five patients undergoing excision for breast lumps were divided into three groups. The first group was administered local EMLA cream preoperatively (Group I, N.=15), the second group (Group II, N.=15) had no preoperative preparation and the third group was placebo group (Group III, N.=15). All groups underwent the operation under local anesthesia. Pain during the local anesthesia and three hours after the operation were assessed using the visual analog scale. The amount of local anesthetic used during the operation and the anesthetic need of patients after the operation were assessed.. When the three groups were compared, it was found that the intensity of pain in the group with EMLA was considerably lower during and after the operation (P<0.05). The amount of local anesthetic used during the operation was lower (P<0.05) and the need for post-operative analgesic was also less than the usual (P<0.05).. Topical EMLA use decreases the pain, provides per-operative and postoperative patient and physician comfort, improved patient's compliance, and simplifies the surgical procedure. This is the first study demonstrating that a topical anesthetic provides a non-invasive analgesia during benign breast mass excision.

Topics: Adolescent; Adult; Anesthesia, Local; Anesthetics, Combined; Breast Neoplasms; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Middle Aged; Prilocaine; Young Adult

Infiltration and topical application of local anaesthetics close to the surgical wound may be used to prevent postoperative pain. We evaluated the efficacy of these treatments after breast surgery for cancer.. Double-blind randomised trial with two treatment groups and one control group.. University hospital, Sweden.. Patients were allocated to treatment with bupivacaine infiltration (n = 29), topical application of lignocaine/prilocaine (n = 31), or no local treatment (n = 30).. Difference and time related patterns in pain scores measured on a visual analogue scale (VAS), and morphine consumption. RESULTS. None of the local anaesthetics significantly reduced the VAS score or morphine consumption. However, fewer patients in the anaesthetic groups had high VAS scores than controls, the 75 centile for the mean score after operation being 2.7, 2.0 and 2.1 for the controls, infiltration, and topical anaesthetic groups, respectively. The controls had higher scores from 6 hours postoperatively onwards. The corresponding median morphine consumption was 24.5, 18.5, and 16.2 mg. CONCLUSIONS. Local anaesthesia slightly reduced the overall pain scores and the morphine consumption, but was of potential clinical value only in the patients who had the highest pain scores.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Analgesia, Patient-Controlled; Anesthetics, Local; Breast Neoplasms; Bupivacaine; Double-Blind Method; Drug Synergism; Female; Humans; Lidocaine; Lidocaine, Prilocaine Drug Combination; Mastectomy, Segmental; Middle Aged; Morphine; Pain Measurement; Pain, Postoperative; Prilocaine; Treatment Outcome

Sentinel lymph node biopsy (SLNB) has been reliably accurate as a minimally invasive surgical alternative for identifying lymphatic breast metastasis. During mapping, the injection of a radioactive tracer or isosulfan blue dye to differentiate the SLN is acutely painful. The use of the eutectic mixture of lidocaine and prilocaine (EMLA) cream to reduce tracer injection pain has been reported anecdotally. A retrospective study compared injection discomfort of 20 women who had undergone SLNB without EMLA and 20 women who had undergone SLNB with the EMLA protocol. Results indicated a significant difference in mean pain rating. Standards of care should include the use of EMLA prior to intradermal SLN tracer injection unless contraindicated.

Topics: Administration, Cutaneous; Anesthetics, Combined; Anesthetics, Local; Breast Neoplasms; Clinical Nursing Research; Drug Monitoring; Female; Humans; Injections, Intradermal; Lidocaine; Lidocaine, Prilocaine Drug Combination; Lymphatic Metastasis; Neoplasm Staging; Nurse's Role; Nursing Assessment; Occlusive Dressings; Oncology Nursing; Pain; Pain Measurement; Prilocaine; Radioisotopes; Radionuclide Imaging; Retrospective Studies; Sentinel Lymph Node Biopsy; Severity of Illness Index; Treatment Outcome