Abstract

Surgery still has a pivotal role in the management of breast cancer & surgery is invariably associated with pain. Present study was aimed to compare post-operative analgesic effects of wound infiltration of equivalent doses with Ropivacaine (0.75%) versus Levobupivacaine (0.5%) in Modified Radical Mastectomy. Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients aged between 20-65 years, belonging to ASA physical status grade I and grade II, weight between 50-70 kg, underwent Modified Radical Mastectomy. At the end of the surgery, before closing the surgical incision, as per the randomization, group R was infiltrated with 0.75% Ropivacaine 20 ml, 13.3 ml of Ropivacaine (0.75%) while Group L was infiltrated with 0.5% Levobupivacaine 20 ml (100 mg). Results: Our study included 60 patients undergoing elective modified radical mastectomy belonging to ASA grade 1 and 2. In the study, there was no significant difference in mean pulse rate between two groups at different time intervals. At 15 minutes, 30 minutes, at 45 minutes, the average MAP was significantly higher in ropivacaine group when compared with that of levobupivacaine group. Despite of being statistically insignificant, the VAS scores at initial intervals (15min, 30mins, and 45mins) were low in group R when compared to group L. At 60 mins and 90 minutes, there was a marked increase in VAS score in group R and thereafter it was akin in two groups. We found that the maximum analgesic effect after wound infiltration was up to 6hrs in both the groups and thereafter the study was terminated. Conclusion: Ropivacaine infiltration provided rapid onset and adequate depth of analgesia in the immediate postoperative hours especially during the initial 90 minutes, whereas levobupivacaine had a slow and constant depth of analgesia. The maximum duration of analgesia noted in our study was 6 hours.

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