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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 3 , 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. Unidad Médica de Alta Especialidad, Hospital de Especialidades de Puebla, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho, Instituto Mexicano del Seguro Social, Puebla de Zaragoza, Pue., México; 4 Directorate of Health Education and Research, Centro Médico Nacional Gral. de Div. Manuel Ávila Camacho. Puebla, Pue., Mexico; 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 Centro de Simulación, Universidad Anáhuac, Ciudad de México. México
*Correspondence: Álvaro J. Montiel-Jarquín. Email: dralmoja@hotmail.com
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.
