Comparison of postoperative pain in diathermy and conventional scalpel Skin incision after mastectomy in Ibadan, Nigeria

Abstract

Introduction: Pain control is a challenge after surgery. Inadequate control of acute postoperative pain in mastectomy patients may lead to chronic post mastectomy pain syndrome. The study aimed to compare the e fleet of diathermy incision with scalpel incision on the severity of acute postoperative pain after mastectomy. Method: Sixty three females had mastectomy under general anaesthesia. Thirty two patients had skin incisions made with scalpel while 31 patients with diathermy. Both groups received intraoperative Fentanyl and Tramadol. Tramadol was also employed as postoperative analgesic while Paracetamol was given as the rescue analgesic. The outcome measures were pain scores using visual analogue score (VAS) and analgesic consumption within the twenty four hours postoperatively. Results: The mean VAS in the diathermy group versus scalpel group at 6th, 12th, 18th and 24th hour post operatively were 11.84 ±6.15mm versus 16.18±8.5mm (p=0.001), 11.10± 4.26mm versus 15.84±5.12mm (p=0.001), 11.07± 4.15mm versus 17.32±6.01mm (p=0.001), 10.6± 8.08mm versus 19.19±8.7mm(p= 0.001) respectively. The mean dose of Tramadol was 264 ±84 mg in the diathermy group versus 278±64 mg in the scalpel group p=0.189, three patients required rescue analgesic (paracetamol) in the diathermy group mean dose 1.57±0.54g versus 7 patients in the scalpel group, mean dose 1.67± 0.58g p=0.75. Conclusion: Diathermy can contribute to reduction in the acute postoperative pain in patients undergoing mastectomy.