Published on October 28, 2015

Narcotic Sparing Breast Surgery

By: Theresa Bowling, MD, Chairman, Department of Anesthesiology

When it comes to breast surgery, we have many different options of relieving pain for our patients, which are unique to the individual’s circumstances and preferences. The breast team at Stamford Hospital works with our anesthesiologists to offer different options so that patients can have control of their pain management.

Narcotic analgesics are often used to relieve pain before and during surgery, but can cause side effects for some individuals such as nausea and vomiting. Breast nerve blocks can be an alternate option.

For outpatient breast surgeries that involve biopsies of lymph nodes, our anesthesiologists offer a variety of ultrasound-guided nerve blocks. Nerve blocks are injections of local anesthetics (numbing medicine) near pain-transmitting nerves that make certain areas of the breast and armpit (lymph node area under the arm) numb. After the patient is sedated, the blocks can be performed in the upper back and/or on the side of the chest depending on the site of surgery. The pain relief from nerve blocks often lasts 18 – 24 hours after the initial injection and many patients require little or no pain medicine afterwards.

For more complex inpatient breast procedures (such as total mastectomy where the entire breast is removed), our anesthesiologists leave a small indwelling plastic tube at the site of the nerve block injection so that numbing medicine can continuously be delivered to the nerves that transmit pain. The catheter gets connected to a disposable pump that delivers numbing medicine at home which can provide continuous pain relief for up to 3 days. Stamford Hospital is unique in the region allowing patients the option of recovering at home and being discharged on post-operative day one pain free. At The Stamford Hospital patients have control over their pain management. You will be given a key to take home with you adjust the rate of your pump to tailor your pain management needs to what is perfect for you.

Advantages of Breast Blocks
  • Eliminate or decrease the need for narcotic pain medication
  • Avoid side effects of narcotic pain medication:
    • Nausea and vomiting
    • Sedation
    • Constipation
  • Faster recovery
  • Decrease incidence of post-mastectomy chronic pain syndrome
  • Possible decrease in breast cancer recurrence and metastasis
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