ABSTRACT
Introduction: Modified radical mastectomy (MRM) isassociated with extensive tissue dissection and substantialpostoperative pain. Various modes of postoperative analgesiahave been used to alleviate the suffering of these patients.One of that is wound instillation, in our study we comparedthe effects of bupivacaine and ropivacaine for post-operativeanalgesia when instilled through the surgical drains in patientsundergoing MRM.Material and methods: After obtaining the InstitutionalEthics Committee approval and written informed consent,60 female patients aged between 18 and 60 years withAmerican Society of Anaesthesiologist status I/II scheduledto undergo MRM were enrolled for the study. Patients wererandomised into two groups (30 each), a total of 40 cc of eitherbupivacaine (0.125%) or ropivacaine (0.2%) instilled throughsurgical drains. Visual analogue score and hemodynamicswere compared in the postoperative period every 2 hourlytill 12 hours. Quantitative data were compared by usingunpaired t-test and qualitative data by using Chi-Square testand Fisher’s Exact test.Results: Duration of analgesia was found to be significantlylonger in bupivacaine group (512.37±63.06 minutes) ascompared to ropivacaine (427.97±43.26 minutes) (p<0.0001). Systolic and diastolic blood pressure were high andstatistically significant in bupivacaine group as compared toropivacaine but clinically not significant.Conclusion: Both local anaesthetics, bupivacaine andropivacaine showed near similar pharmacological effectshowever the duration of analgesia was observed more withbupivacaine when instilled through the surgical drains. Woundinstillation, being a non-invasive technique is an effectivemode of providing postoperative analgesia in MRM ascompare to other invasive modalities.