Purpose Breast reduction is one of the most frequently performed plastic surgical procedures in the United States, with over 113,000 patients undergoing the procedure in 2003. The medial pedicle breast reduction is being performed on a more frequent basis in recent years. As with other surgical procedures, there has been a paradigm shift toward outpatient surgery when safe and feasible. At present, many of the patients who undergo outpatient reduction mammoplasty report that the greatest period of postoperative discomfort is the first 48 hours. The goal of our study is to provide a safe, inexpensive agent (less than fifteen dollars per patient) to patients in the operating room that will not only decrease the amount of narcotic requirements during the postoperative recovery period, but also to allow patients to be discharged from the recovery room faster.

Methods A randomized, double blinded prospective trial comparing the use of Sensorcaine intraoperatively versus placebo was conducted starting October 2004 and is ongoing. After an informed discussion, patients were randomized to either placebo or Sensorcaine (0.25%, 10cc injected into each breast drain during final closure). Patients were followed closely in the postoperative period and the amount of pain experienced was assessed using the visual analog scale as a standard part of the recovery room nursing protocol. The nursing staff recorded pain medication utilization and time spent in recovery room. After discharge, the patients were asked to record when and how much pain medication was taken. A statistical comparison was made between the two patient groups. All patients received the same postoperative pain medication (Vicodin).

Results Patient age or resection weight did not vary between the two groups. Out of thirty-two patients in the study, 17 received Sensorcaine. Comparing mean recovery room stay, the patients who received Sensorcaine spent less time in the hospital (3 hrs vs 3.8 hrs, p=0.023). Postoperative pain medication consumption was less for patients who received Sensorcaine (3.1 tabs vs 6.8 tabs, p=0.034) over the first three days. There were no complications related to Sensorcaine usage.

Conclusion This prospective, double blinded, randomized study demonstrated that a single dose of Sensorcaine provided a safe and efficacious way to improve the immediate postoperative recovery in patients undergoing medial pedicle breast reduction. Time spent in recovery room and postoperative pain medication consumption were statistically less when patients received intraoperative Sensorcaine.