Comparative study of lidocaine- saline versus saline as washout for lumpectomy cavity on acute postoperative pain

Heliyon. 2024 Oct 11;10(20):e39265. doi: 10.1016/j.heliyon.2024.e39265. eCollection 2024 Oct 30.

Abstract

Purpose: This study aimed to evaluate the impact of lidocaine-saline solution compared to saline alone for washing out the lumpectomy cavity, focusing on its effect on acute postoperative pain-a prevalent and significant concern among patients undergoing breast surgery.

Methods: In this comparative study, 72 patients scheduled for lumpectomy surgery were randomly assigned to either the lidocaine-saline or saline group. The lidocaine-saline group was administered a washout of the lumpectomy cavity with 2 % lidocaine at a dosage of 1.75 mg/kg in 0.9 % normal saline, whereas the saline group received a washout with an equivalent volume of 0.9 % normal saline. We recorded the participants' basic characteristics, heart rate, blood pressure, the incidence and intensity of pain (measured by the visual analogue scale), and the usage of postoperative analgesics.

Results: The two study groups did not differ significantly in their basic characteristics, heart rate and blood pressure. The saline group had significantly higher pain intensity than the lidocaine-saline group at 30 min after surgery (4.61 vs. 2.88, P < 0.0001) and at all other time points (P < 0.001). The saline group also took the first dose of analgesics earlier than the lidocaine-saline (46.66 Vs. 170.55 min, P < 0.001) and used a significantly higher mean dose of meperidine (77.50 mg vs 33.47 mg, P < 0.001).

Conclusion: The use of a lidocaine-saline wash during lumpectomy procedures can significantly reduce postoperative pain and lower the necessity for analgesics in patients who have undergone breast surgery.

Keywords: Breast surgery; Lidocaine; Lumpectomy; Postoperative pain; Saline solution.