Improved Pain Relief Using Intermittent Bupivacaine Injections at the Donor Site After Breast Reconstruction with Deep Inferior Epigastric Perforator Flap

Abstract

Deep inferior epigastric perforator flap surgery usually results in postoperative pain from the donor site requiring opioids. We examined the effect of bupivacaine 2.5 mg/mL, 20 mL given every third hour for 72 hours postoperatively through 2 thin catheters placed on the donor site in a double-blind placebo-controlled study consisting of 2 x 20 patients. The bupivacaine group had significantly reduced pain at rest and during coughing. The placebo group needed 2 to 3 times more opioids in the 72-hour observation period. No difference was seen in the frequency of nausea or the consumption of antiemetic drugs. We conclude that intermittent delivery of bupivacaine at the abdominal donor site significantly reduces the postoperative pain and need for narcotic rescue medication.