J Breast Cancer.  2006 Dec;9(4):349-353. 10.4048/jbc.2006.9.4.349.

The analgesic effects of intercostal nerve block in patients undergoing augmentation mammoplasty: MDbP 203

• Lee S
• Kwon S

• KMID: 2286608
• DOI: http://doi.org/10.4048/jbc.2006.9.4.349

Abstract

PURPOSE: Augmentation mammoplasty is a procedure that expands the breast tissue and pectoral muscle by insertion of an implant. This procedure induce extreme postoperative pain. The purpose of this study was to determine whether intercostal nerve block (ICNB) could reduce the pain after augmentation mammoplasty.
METHODS
Eighty three patients, who underwent augmentation mammoplasty, at the M.D. Clinic between December 2005 and February 2006, were the cases of this study. We injected 0.25% ropivacaine (total 30ml per side) in the ICNB group (n=68) into the 3,4,5 and 6th intercostals spaces following induction of general anesthesia for surgery. The mean arterial pressures and heart rates were measured before and after subpectoral dissection. A numerical rating scale (NRS: 0=no pain, 10= most severe pain) was used to measure the pain postoperative 6, 24, 48 hours, respectively. We statistically compared the ICNB group with the control group (n=15) with using the Mann-Whitney Rank Sum test.
RESULTS
The mean arterial pressures and heart rates were more stable during subpectoral dissection in the ICNB group than in the control group (p= 0.142 and p= 0.037). The NRSs were lower throughout the 48 hours of the postoperative period in the ICNB group than in the control group (p<0.001 at 6hr, p=0.017 at 24hr, p=0.054 at 48hr).
CONCLUSION
ICNB induced stable vital sign during subpectoral dissection and excellent postoperative pain control during 48 hours postoperatively for those patients undergoing augmentation mammoplasty.

Keyword

intercostal nerve block; augmentation mammoplasty

MeSH Terms

Anesthesia, General
Arterial Pressure
Breast
Female
Heart Rate
Humans
Intercostal Nerves*
Mammaplasty*
Pain, Postoperative
Postoperative Period
Vital Signs

Figure

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  Fig 1 Intercostal nerve block. Injection of 0.25% ropivacaine into the 3,4,5 and 6th intercostals spaces.

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  Fig 2 Changes of mean arterial pressure after subpectoral dissection

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  Fig 3 Change of heart rate after subpectoral dissection

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  Fig 4 Time course changes of postoperative numerical rating scale.

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