TITLE:
Comparative Study between Lidocaine 2% and Dexamethasone Local Wound Infiltration Effect on Postoperative Pain Post Mastectomy: A Randomized Controlled Study
AUTHORS:
Hussein O. Soliman
KEYWORDS:
Post-Mastectomy Pain, Lidocaine, Dexamethasone
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.7 No.4,
August
31,
2018
ABSTRACT: Objective: To compare the efficacy and safety of Lidocaine 2% versus Dexamethasone
injected locally in mastectomy wound as pain relieving agents. Materials & Methods:
A randomized single-blinded study in which 50 patients candidate for Mastectomy
were included. Participants were equally randomized into two groups; Group A, in
which patients received 10 ml Lidocaine 2% and Group B, in
which patients received 16 mL Dexamethasone. In both groups, the drugs were
given via local infiltration in the subcutaneous layer of the Mastectomy wound
immediately after skin closure. Pain control was assessed post-operatively in
the first 24 hours using the visual analogue scale (VAS) in addition the need
for additional analgesia was recorded. Results: There was a statistically
significant lower VAS score in group A (Lidocaine group) when compared to those
in group B (Dexamethasone group) 1 h, 6 h, 12 h postoperatively with no
significance 24 h postoperatively (36% vs 64% 1 h, 28% vs 64% 6 h, 30% vs 72%
12 h and, 80% vs 60% 24 h). This statistical significance was evident throughout
the post-operative hours (1 h, 6 h, 12 h). Though local Lidocaine caused marked improvement of pain
in bigger number of patients in group A than group B, yet it showed no
statistical significance 24 h post-mastectomy. Furthermore, the number of
participants that needed additional doses of analgesia lower in group A (48% vs
56%) in comparison to group B, but still showed no statistical significance. Conclusion:
Local injection of Lidocaine 2% in Mastectomy wounds, has an upper hand in
reducing the post-operative pain and showed a lesser need for post-operative
analgesia when compared to local Dexamethasone injection.