Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Effects of Postoperative Wound Infiltration Analgesia with Bupivacaine or Diclofenac on Long-Term Outcomes in Patients After Breast Cancer Surgery

Josipa Glavas Tahtler
,
Dajana Djapic
,
Marina Neferanovic
,
Jelena Miletic
,
Marta Milosevic
,
Kristina Kralik
,
Nenad Neskovic
,
Ilijan Tomas
,
Dora Mesaric
,
Ksenija Marjanovic
,
Jasmina Rajc
,
Zelimir Orkic
,
Ana Cicvaric
,
Slavica Kvolik
* ORCID logo
Version 1 : Received: 31 July 2023 / Approved: 1 August 2023 / Online: 2 August 2023 (04:37:34 CEST)

How to cite: Tahtler, J.G.; Djapic, D.; Neferanovic, M.; Miletic, J.; Milosevic, M.; Kralik, K.; Neskovic, N.; Tomas, I.; Mesaric, D.; Marjanovic, K.; Rajc, J.; Orkic, Z.; Cicvaric, A.; Kvolik, S. Effects of Postoperative Wound Infiltration Analgesia with Bupivacaine or Diclofenac on Long-Term Outcomes in Patients After Breast Cancer Surgery. Preprints 2023, 2023080130. https://doi.org/10.20944/preprints202308.0130.v1 Tahtler, J.G.; Djapic, D.; Neferanovic, M.; Miletic, J.; Milosevic, M.; Kralik, K.; Neskovic, N.; Tomas, I.; Mesaric, D.; Marjanovic, K.; Rajc, J.; Orkic, Z.; Cicvaric, A.; Kvolik, S. Effects of Postoperative Wound Infiltration Analgesia with Bupivacaine or Diclofenac on Long-Term Outcomes in Patients After Breast Cancer Surgery. Preprints 2023, 2023080130. https://doi.org/10.20944/preprints202308.0130.v1

Abstract

Breast cancer is the most common malignant disease in women. Preclinical studies have confirmed that the local anesthetic levobupivacaine has a cytotoxic effect on breast cancer cells. We examined whether postoperative wound infiltration with levobupivacaine influences survival in 120 patients who were operated on for breast cancer and underwent quadrantectomy or mastectomy with axillary lymph node dissection. Groups with continuous levobupivacaine wound infiltration, bolus wound infiltration, and diclofenac analgesia were compared. Long-term outcomes examined were quality of life, shoulder disability, and hand grip strength (HGS) after one year, and survival after 5 and 10 years. Groups that had infiltration analgesia had better shoulder function compared to diclofenac after one year. Levobupivacaine PCA group had the best preserved HGS after 1 year (P=0.022). The most significant predictor of the 5-year outcome was HGS (P=0.03). Although the best survival after 5 and 10 years was registered in the bolus levobupivacaine group, statistical significance was not reached (P=0.36). The extent of the disease at the time of surgery is the most important predictor of long-term survival. A larger prospective clinical study could better confirm the effect of levobupivacaine wound infiltration on outcomes after breast cancer surgery observed in this pilot study. Trial number NCT05829707

Keywords

Breast Cancer; Acute Postoperative Pain; Postoperative analgesia; Patient-Controlled Analgesia; Levobupivacaine; Diclofenac; Hand Grip Strength; Quality of life; Treatment Outcome; Long term survival.

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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