A Comparison of Tumescence in Breast Reduction Surgery
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Post-Surgical Pain, Hospital |
| Therapuetic Areas: | Musculoskeletal, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | August 2012 |
| End Date: | October 2015 |
The investigators' main hypothesis is that in breast reduction surgery, the use of tumescent
solution containing both dilute lidocaine and epinephrine will lead to better control of
postoperative pain, nausea, vomiting, shorter time through postoperative phases of care,
quicker discharge from the hospital and lower numbers of hospital readmissions than the use
of tumescent solution containing only dilute epinephrine.
solution containing both dilute lidocaine and epinephrine will lead to better control of
postoperative pain, nausea, vomiting, shorter time through postoperative phases of care,
quicker discharge from the hospital and lower numbers of hospital readmissions than the use
of tumescent solution containing only dilute epinephrine.
Postoperative pain is often undermanaged in surgical patients. In the outpatient surgery
population, such as breast reduction surgery, postoperative pain can lead to increased
narcotic use, increased nausea, surgical complications and unplanned hospital admission, in
addition to patient discomfort or dissatisfaction. Tumescence is a method of infiltrating
tissues, such as the breast, with solutions of very dilute lidocaine and/or very dilute
epinephrine in order to provide diffuse local anesthesia, hemostasis, and tissue
manipulation. Both types of solution are considered standard care and both at the University
of Wisconsin, Madison. There are two main aims to this study. Aim 1 is to determine the
effect of dilute lidocaine in tumescent solution on post-operative pain following breast
reduction surgery. Aim 2 of our study is to determine the effect of dilute lidocaine in
tumescent solution on secondary post-operative outcomes following breast reduction surgery.
The secondary outcomes that will be measured in this study include average time (minutes)
spent in the PACU, average time (minutes) spent in Phase 2, total time (minutes) between the
end of case and discharge home, occurrence of unplanned hospital admission, number of
episodes of post-operative nausea (subjective feeling vs. emesis) and amount of anti-emetic
medication used in pacu, phase 2 and the first 24 hours post-op. (mg). The investigators
hypothesize that tumescence with lidocaine and epinephrine will have improved post-operative
pain control leading to less narcotic use during the first twenty four hours
postoperatively. (Aim 1). The investigators also believe that tumescence with lidocaine and
epinephrine will lead to less time spent in PACU, less time spent in Phase2, less time
between the end of the case and discharge home, less occurrence of unplanned hospital
admissions, less episodes of post-operative nausea and less amount of antiemetic medication
used in PACU, phase 2 and the first 24 hours post-op (Aim 2). The investigators propose that
such differences could play a significant role in surgical outcomes and patient satisfaction
in outpatient plastic surgery.
population, such as breast reduction surgery, postoperative pain can lead to increased
narcotic use, increased nausea, surgical complications and unplanned hospital admission, in
addition to patient discomfort or dissatisfaction. Tumescence is a method of infiltrating
tissues, such as the breast, with solutions of very dilute lidocaine and/or very dilute
epinephrine in order to provide diffuse local anesthesia, hemostasis, and tissue
manipulation. Both types of solution are considered standard care and both at the University
of Wisconsin, Madison. There are two main aims to this study. Aim 1 is to determine the
effect of dilute lidocaine in tumescent solution on post-operative pain following breast
reduction surgery. Aim 2 of our study is to determine the effect of dilute lidocaine in
tumescent solution on secondary post-operative outcomes following breast reduction surgery.
The secondary outcomes that will be measured in this study include average time (minutes)
spent in the PACU, average time (minutes) spent in Phase 2, total time (minutes) between the
end of case and discharge home, occurrence of unplanned hospital admission, number of
episodes of post-operative nausea (subjective feeling vs. emesis) and amount of anti-emetic
medication used in pacu, phase 2 and the first 24 hours post-op. (mg). The investigators
hypothesize that tumescence with lidocaine and epinephrine will have improved post-operative
pain control leading to less narcotic use during the first twenty four hours
postoperatively. (Aim 1). The investigators also believe that tumescence with lidocaine and
epinephrine will lead to less time spent in PACU, less time spent in Phase2, less time
between the end of the case and discharge home, less occurrence of unplanned hospital
admissions, less episodes of post-operative nausea and less amount of antiemetic medication
used in PACU, phase 2 and the first 24 hours post-op (Aim 2). The investigators propose that
such differences could play a significant role in surgical outcomes and patient satisfaction
in outpatient plastic surgery.
Inclusion Criteria:
- all patients presenting for breast reduction surgery at the University of Wisconsin
Hospital and Clinics and the University of Wisconsin Transformations Surgery Center
and who do not meet any of the exclusion criteria.
Exclusion Criteria:
- Women under the age of 18 years
- Breast feeding or pregnant women
- Incarcerated women.
- Women unable to give consent because of impaired decision making ability.
- Women who have reported allergies to the substances that will be used in the study.
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