A double blind randomized trial of wound infiltration with ropivacaine after breast cancer surgery with axillary nodes dissection

Patients scheduled for mastectomy or tumorectomy and axillary nodes dissection had immediate postoperative infiltration of the surgical wound with 20 ml of ropivacaine 7.5 mg.ml-1 or isotonic saline. Pain was assessed on a visual analogue scale at H2, H4, H6, H12, H24, H72, and at 2 month, at rest and on mobilization of the arm. Patient'comfort was evaluated with numerical 0-3 scales for fatigue, quality of sleep, state of mood, social function and activity.Twenty-two and 24 patients were included in the ropivacaine and saline groups respectively. Postoperative pain was lower at rest and on mobilization at 2, 4 and 6 hour after surgery in the ropivacaine group. No other difference in pain intensity and patient 'comfort scoring was documented during the first 3 postoperative days. Patients did not differ at 2 month for pain and comfort scores.Single shot infiltration with ropivacaine transiently improves postoperative pain control after breast cancer surgery.NCT01404377Surgical wound infiltration with a local anaesthetic solution is currently performed in many surgical procedures including, abdominal hysterectomy, caesarean section and inguinal hernia repair [1]. Wound infiltration is reported to provide immediate postoperative pain control lasting for several hours [2]. In addition, long term benefits have been suggested such as prevention of chronic pain syndrome after surgery [1]. Breast cancer surgery is associated with mild to moderate pain but some procedures including axillary nodes dissection are more painful [3]. In these patients, pain may impair postoperative comfort and may prevent from mobilization of the corresponding upper limb. Moreover, studies have pointed out that chronic pain syndromes may develop after breast surgery that could be, at least partly, related to the intensity of acute postoperative pain and axillary nodes dissection [4]. Local infiltration with a local anaesthetic solution, has been studied on several instances with disappointing re