Anesthetic efficacy of local infiltration of 1% lidocaine plus 0.2% ropivacaine compared with 2% lidocaine in ambulatory breast surgery




Gerardo Sánchez-Juárez, 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
Gisela Alonso-Torres, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, México
Álvaro J. Montiel-Jarquín, 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, Pue., Puebla, México
Arturo García-Galicia, 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, Pue., Puebla, México
Nancy R. Bertado-Ramírez, 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, Pue., Puebla, México
Esmeralda Gracián-Castro, Facultad de Medicina, Universidad Popular Autónoma del Estado de Puebla, Puebla, México
Marco A. González-Martínez, Dirección de Educación e Investigación en Salud, Hospital de Especialidades de Puebla, Centro Médico Nacional General de División Manuel Ávila Camacho, IMSS, Puebla, México
Jorge Loría-Castellanos, Coordination of Special Health Projects, Instituto Mexicano del Seguro Social, Mexico City, Mexico


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.