Postoperative Pain Control by Intercostal Nerve Block After Augmentation Mammoplasty

In breast augmentation with implant, there is severe pain due to damage from expansion of breast tissue and the pectoralis major. Therefore, the authors conducted this study to analyze the effectiveness of postoperative intercostal nerve block (ICNB) in reducing postoperative pain after breast augmentation with implant. Forty-four female patients were enrolled in the study. Just before awaking from general anesthesia, 34 cases were injected with 0.2% ropivacaine to both third, fourth, fifth, and sixth intercostal spaces. We compared them (ICNB group) with the control group for VAS scores at the time of arrival in the recovery room, after 30, 60, and 120 min. The average VAS scores per time of the control group and ICNB group were 7.1 +/- 0.74 and 3.50 +/- 1.81 at arrival time in the recovery room, 7.00 +/- 0.67 and 3.03 +/- 1.47 after 30 min, 5.50 +/- 0.71 and 2.68 +/- 1.49 after 60 min, and 4.60 +/- 0.84 and 2.00 +/- 1.35 after 120 min. VAS scores of two groups were significantly different at each time and decreased overall. Also, time and group effect of the two groups were significantly different, especially between 30 and 60 min. ICNB just before awaking from general anesthesia showed a statistically significant reduction in VAS score, and this means postoperative pain was reduced effectively and time to discharge could be shortened. Therefore, it can be a good way to reduce postoperative pain after augmentation mammoplasty with implant.