Breast reconstruction with tissue expander is known to be the most painful procedure among breast surgical procedures and is more painful than mastectomy or axillary dissection. This fact was confirmed with National Mastectomy and Breast Reconstruction Audit in England in 2011. Severe pain was traditionally treated with intravenous narcotic analgesia. We are still searching for more effective non-opioid methods relieving pain in order to reduce the use of narcotics.
In the last decade it becomes obvious that local anesthetics are a good treatment option. Lu and Fine have shown the efficacy of continuous local anesthetic infusion after breast reduction mammoplasty and reconstruction. He compared consecutive patients treated with continuous local anesthetic infusion and patients, who were treated with traditional opioid method before the study.