Local irrigation with bupivacaine + ketorolac may decrease pain one hour post-surgery. Furthermore, local anesthesia may minimize postsurgery narcotic use.

A systematic review and network meta-analysis assessed effectiveness of local analgesics for postsurgery pain alleviation in augmentation surgery of the breast.

Notably, 3 databases were searched for trials assessing the results of wound irrigation with local analgesics during or after surgery of the breast. The solutions incorporated were bupivacaine, ropivacaine, and bupivacaine + ketorolac. No irrigation or saline alone were the control groups.

Based on the frequentist approach, network meta-analysis was additionally employed. The results of the study were stated as the weighted mean differences along with 95% confidence intervals.

Only bupivacaine + ketorolac (vs placebo) substantially decreased pain at one hour postoperatively, as revealed by the visual analog scale (VAS) pain score decrease of 2.22 (− 3.98, − 0.47). Regarding other comparisons, no profound differences were noted.

Furthermore, 3 of the incorporated studies reported postsurgery medication use and 2 of them stated that postsurgery narcotic use was lowered. However, the others did not report any such decrease.

In people scheduled to undergo breast augmentation surgery, the combination of bupivacaine and ketorolac appears to be beneficial for postoperative pain control. Additional research is warranted to further confirm the clinical benefits of local anesthesia in breast augmentation.