Local Anaesthetic Wound Catheter Use After Implant Based Breast Reconstruction - Towards Enhanced Recovery
Association of Breast Surgery ePoster Library. Harvey K. 05/15/17; 166266; P095
Ms. Kate Harvey
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Abstract
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Introduction:
After implant-based breast reconstruction (IBBR) pain and nausea can contribute to reduced mobility and extended hospital stay. Use of local anaesthetic (LA) catheters to bathe the operative site has become routine following IBBR in our unit. The aim of this retrospective cohort study was to compare outcomes between two patient groups, one with and one without LA catheters.
Primary Outcome: Reduced post-operative pain (using surrogates including pain-scores and opiate use)
Secondary outcomes: PONV, antiemetic use, LOS and complications rates.
Methods:
Electronic and paper records were used to identify groups with and without LA catheters and compare the two groups.
Results:
20 patients underwent IBBR with LA catheters between February 2014-May 2016 (catheter group) and 15 patients without LA catheters between September 2011-February 2014 (control group). 10% of patients in the catheter group required additional opioids in recovery compared with 40% in the control group (p=0.03) The catheter group also used relatively less NSAIDS, codeine and oro-morph in the first 48hours post-op. 95% of patients in the catheter group were discharged by the end of day 3, compared to 74% of the controls. Complication rates were similar between the groups.
Conclusions:
LA wound catheters are not associated with increased complications and can be used safely in IBBR. Post-operative opioid use was significantly reduced in the catheter group. There has been a move towards shorter LOS; good post-operative analgesia has contributed to this. Routine use of LA wound catheters will form part of our unit's future enhanced recovery plan following IBBR.
After implant-based breast reconstruction (IBBR) pain and nausea can contribute to reduced mobility and extended hospital stay. Use of local anaesthetic (LA) catheters to bathe the operative site has become routine following IBBR in our unit. The aim of this retrospective cohort study was to compare outcomes between two patient groups, one with and one without LA catheters.
Primary Outcome: Reduced post-operative pain (using surrogates including pain-scores and opiate use)
Secondary outcomes: PONV, antiemetic use, LOS and complications rates.
Methods:
Electronic and paper records were used to identify groups with and without LA catheters and compare the two groups.
Results:
20 patients underwent IBBR with LA catheters between February 2014-May 2016 (catheter group) and 15 patients without LA catheters between September 2011-February 2014 (control group). 10% of patients in the catheter group required additional opioids in recovery compared with 40% in the control group (p=0.03) The catheter group also used relatively less NSAIDS, codeine and oro-morph in the first 48hours post-op. 95% of patients in the catheter group were discharged by the end of day 3, compared to 74% of the controls. Complication rates were similar between the groups.
Conclusions:
LA wound catheters are not associated with increased complications and can be used safely in IBBR. Post-operative opioid use was significantly reduced in the catheter group. There has been a move towards shorter LOS; good post-operative analgesia has contributed to this. Routine use of LA wound catheters will form part of our unit's future enhanced recovery plan following IBBR.
Introduction:
After implant-based breast reconstruction (IBBR) pain and nausea can contribute to reduced mobility and extended hospital stay. Use of local anaesthetic (LA) catheters to bathe the operative site has become routine following IBBR in our unit. The aim of this retrospective cohort study was to compare outcomes between two patient groups, one with and one without LA catheters.
Primary Outcome: Reduced post-operative pain (using surrogates including pain-scores and opiate use)
Secondary outcomes: PONV, antiemetic use, LOS and complications rates.
Methods:
Electronic and paper records were used to identify groups with and without LA catheters and compare the two groups.
Results:
20 patients underwent IBBR with LA catheters between February 2014-May 2016 (catheter group) and 15 patients without LA catheters between September 2011-February 2014 (control group). 10% of patients in the catheter group required additional opioids in recovery compared with 40% in the control group (p=0.03) The catheter group also used relatively less NSAIDS, codeine and oro-morph in the first 48hours post-op. 95% of patients in the catheter group were discharged by the end of day 3, compared to 74% of the controls. Complication rates were similar between the groups.
Conclusions:
LA wound catheters are not associated with increased complications and can be used safely in IBBR. Post-operative opioid use was significantly reduced in the catheter group. There has been a move towards shorter LOS; good post-operative analgesia has contributed to this. Routine use of LA wound catheters will form part of our unit's future enhanced recovery plan following IBBR.
After implant-based breast reconstruction (IBBR) pain and nausea can contribute to reduced mobility and extended hospital stay. Use of local anaesthetic (LA) catheters to bathe the operative site has become routine following IBBR in our unit. The aim of this retrospective cohort study was to compare outcomes between two patient groups, one with and one without LA catheters.
Primary Outcome: Reduced post-operative pain (using surrogates including pain-scores and opiate use)
Secondary outcomes: PONV, antiemetic use, LOS and complications rates.
Methods:
Electronic and paper records were used to identify groups with and without LA catheters and compare the two groups.
Results:
20 patients underwent IBBR with LA catheters between February 2014-May 2016 (catheter group) and 15 patients without LA catheters between September 2011-February 2014 (control group). 10% of patients in the catheter group required additional opioids in recovery compared with 40% in the control group (p=0.03) The catheter group also used relatively less NSAIDS, codeine and oro-morph in the first 48hours post-op. 95% of patients in the catheter group were discharged by the end of day 3, compared to 74% of the controls. Complication rates were similar between the groups.
Conclusions:
LA wound catheters are not associated with increased complications and can be used safely in IBBR. Post-operative opioid use was significantly reduced in the catheter group. There has been a move towards shorter LOS; good post-operative analgesia has contributed to this. Routine use of LA wound catheters will form part of our unit's future enhanced recovery plan following IBBR.
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