Patient satisfaction and perioperative data after breast surgery in tumescent local anaesthesia

Tumescent local anaesthesia (TLA) is an upcoming alternative to general anaesthesia. No data exists regarding patient satisfaction, necessary volume of TLA, frequency of supplementary analgosedation, and associated complication rate after different kinds of breast surgeries in TLA.

In this retrospective study 104 patients, who underwent breast surgery in TLA between 1/2022 and 1/2023, answered a questionnaire. Patients were categorized according to histology and surgical complexity into two groups: those with benign histology undergoing minor procedures (outpatients) and those with malignant histology undergoing more complex surgical procedures (inpatients). Perioperative data was retrieved from the patients' files.

96.1% of all patients were (very) satisfied with the surgery, with inpatients being significantly more satisfied (p = 0.022). No significant differences were observed between the groups regarding perception of TLA-infiltration, likelihood of recommending the procedure in TLA, or willingness to undergo the procedure again in TLA. Six patients (5.8%) had postoperative complications with no significant difference in frequency of complications. Outpatients needed significantly less TLA-volume (184.7ml ± 131.4 ml), compared to inpatients with a total TLA-volume of 473.3 ml ± 205.2 ml (p < 0.001). 25 patients (24.0%) opted for an intraoperative midazolam sedation (mean 1.5 mg, SD 0.9mg), predominantly in more extensive procedures.

Patients' high satisfaction and recommendation level and the low rate of complications are convincing reasons to offer TLA as an alternative to general anaesthesia for a large spectrum of breast surgeries.