Abstract: Traumatic Cleft Helix of Ear Repair Using Z-Plasty with Criss-Cross Flap

METHODS: This study was a prospective, randomized, placebo controlled double blind clinical trial with ethical approval. Thirty-two consecutive women undergoing subpectoral breast augmentation were enrolled. Patient received general anesthesia and were allocated randomly to two study groups. Patient in group 1 received intercostal nerve block using 10 ml of 0.25% bupivacaine with epinephrine in one side of the breast and normal saline in another side prior to implant placement. Patient in group2 received locally administered of 20 ml of 0.25% bupivacaine with epinephrine at the surgical site in one side of breast and placebo infiltration of normal saline in the contralateral breast. Both the patient and evaluator were blinded to the side given anesthesia and method of anesthesia used. Primary outcome was pain measured with the visual analogue scale recorded at 2, 6, 12, 24 and 48 hours at rest and after movement. Pain score was compared between breasts (anesthesia vs placebo) and between types of anesthesia. By comparing analgesic outcomes in the same patients, we could control for the subjectivity of pain assessments. A p-value of < 0.05 was considered statistically significant.