Alghamdi Maysaa, Alsayed Bader, Albenmousa Fatimah, Salleh Sumayyah Bin, Alqaysi Luba, Alfayez Joud, Mandoorah Joana, Alanzi Reem, Alshayeqe Ghina, Albaqmi Sara, Sabi Ahmed, Arif Sultan, Mortada Hatan
College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia.
Aesthetic Plast Surg. 2025 Jan;49(1):156-163. doi: 10.1007/s00266-024-04249-x. Epub 2024 Jul 8.
Aesthetic breast surgeries, including breast reduction, are commonly performed surgical procedures associated with postoperative pain. Pain control is essential to patient comfort, satisfaction, and early recovery. This systematic review is the first to conduct both qualitative and quantitative analysis to evaluate the efficacy and safety of local anesthetic infiltration in reducing pain after breast reduction surgeries.
This systematic review is registered in PROSPERO, assessed for bias using the RoB2 tool, and follows the PRISMA guidelines. A full electronic search was performed in different databases for all clinical papers on adult female patients undergoing cosmetic breast reduction surgery who were given local anesthetic infiltration for postoperative pain relief.
A systematic review of five randomized clinical trials with a total of 191 patients found that local anesthetic infiltration significantly reduces postoperative pain in breast reduction surgery, reduces opioid consumption, and improves patient outcomes. A meta-analysis of two trials reported the mean VAS score for postoperative pain in the local anesthetic and placebo groups.
A systematic review and a meta-analysis show a significant reduction in postoperative pain following local anesthetic infiltration, but further research is needed to understand its effectiveness and potential adverse effects.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
包括乳房缩小术在内的美容性乳房手术是常见的外科手术，术后常伴有疼痛。疼痛控制对于患者的舒适度、满意度和早期康复至关重要。本系统评价首次进行定性和定量分析，以评估局部麻醉药浸润在减轻乳房缩小术后疼痛方面的疗效和安全性。
本系统评价已在国际前瞻性系统评价注册库（PROSPERO）注册，使用RoB2工具评估偏倚，并遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。在不同数据库中进行全面的电子检索，查找所有关于接受美容性乳房缩小手术的成年女性患者使用局部麻醉药浸润以缓解术后疼痛的临床研究论文。
对五项随机临床试验（共191例患者）的系统评价发现，局部麻醉药浸润可显著减轻乳房缩小手术的术后疼痛，减少阿片类药物的使用，并改善患者预后。对两项试验的Meta分析报告了局部麻醉药组和安慰剂组术后疼痛的平均视觉模拟评分（VAS）。
系统评价和Meta分析表明，局部麻醉药浸润可显著减轻术后疼痛，但需要进一步研究以了解其有效性和潜在不良反应。
证据级别I：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
