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Anesthetic efficacy of local infiltration of 1% lidocaine plus 0.2% ropivacaine compared with 2% lidocaine in ambulatory breast surgery
Anesthetic efficacy of local infiltration of 1% lidocaine plus 0.2% ropivacaine compared with 2% lidocaine in ambulatory breast surgery
Gerardo Sánchez-Juárez 1, Gisela Alonso-Torres 2, Álvaro J. Montiel-Jarquín 3 
, Arturo García-Galicia 4 , Nancy R. Bertado-Ramírez 4 , Esmeralda Gracián-Castro 5, Marco A. González-Martínez 6, Jorge Loría-Castellanos 7
1 Servicio de Anestesiología, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS), Puebla, México; 2 Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, México; 3 Dirección de Educación e Investigación en Salud, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social (IMSS) Puebla, México; 4 Dirección de Educación e Investigación en Salud. Hospital de Especialidades de Puebla, Instituto Mexicano del Seguro Social, Puebla, Pue., México; 5 Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Puebla, México; 6 Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, IMSS, Puebla, México; 7 Coordinación de Proyectos Especiales en Salud, Instituto Mexicano del Seguro Social, Ciudad de México, México
*Correspondence: Álvaro J. Montiel-Jarquín. Email: alvaro.montielj@imss.gob.mx
Abstract
Background: Breast biopsy is generally performed on an outpatient basis; local anesthetics of the amide group are used; their combination is little studied.
Objective: To assess anesthetic efficacy of 1% lidocaine plus 0.2% ropivacaine versus 2% lidocaine in breast biopsy.
Methods: Comparative study in patients scheduled for breast biopsy, randomized in: group A (ropivacaine 0.2% with lidocaine 1%) and group B (lidocaine 2%). Anesthesia was evaluated with the Verbal Numerical Pain Scale at 5 minutes post-anesthesia, and at 15 and 30 minutes post-surgery. Subsequent dose and sedation (fentanyl 50 μg single bolus) requirements and toxicity were recorded. Descriptive statistics, Student’s t and Fisher’s exact tests were used.
Results: Group A, 18 women, mean age 46.56 years (SD: 14.25), mean doses ropivacaine 88.19 mg (SD: 21.28.) and lidocaine 123.89 mg (SD: 17.19). Group B, 18 women, mean age 46.94 years (SD: 16.09), mean dose lidocaine 135 mg (SD: 21.21). Both groups reported effective anesthesia. Subsequent doses: group B, 17 (94.4%) patients. Sedation: group A, 11 (61.1%) patients, and group B 15 (83.3%) patients. No significant differences in anesthesia (p = 0.33), subsequent doses (p = 0.80) and sedation (p = 0.28); no toxicity.
Conclusions: In breast biopsies, the efficacy and anesthetic safety of 0.2% ropivacaine plus 1% lidocaine versus 2% lidocaine are not different.
Keywords: Biopsy. Female breast biopsy. Breast cancer. Local anesthesia. Anesthetic efficacy.
