Background: PMPS nowadays is common due to advances in both; diagnosis and treatment of cancer breast.Choosing proper treatments can improve the patients' quality of life. Cancer breast is common and quite important disease and female in our family must be aware of it. Improvement of the diagnosis and treatment PMPS lead to increased patients satisfaction and decrease fear of cancer breast.Objective: Discuss different methods for management of PMPS with less side effects, adequate analgesia, improvement of quality of life, and better patient satisfaction in the future. Methods: Treatment approaches include both pharmacological interventions and non-pharmacologicalstrategies. However, current treatments of the PMPS are near-optimal and prevention much better than treatment. Conclusion:Continuous perioperative thoracic epidural Fentanyl-bupivacaine infusion was much better in pain relief, less sedating effect and shorter duration of hospital and ICU stay than continuous perioperative entanyl intravenous infusion in patients undergoing major upper gastrointestinal cancer surgery.

Background and objectivesMajor abdominal cancer surgeries are associated with significant perioperative mortality and morbidity due to myocardial ischemia and infarction. This study examined the effect of perioperative patient controlled epidural analgesia (PCEA) on occurrence of ischemic cardiac injury in ischemic patients undergoing major abdominal cancer surgery.Patients and methodsOne hundred and twenty patients (American Society of Anesthesiologists grade II and III) of either sex were scheduled for elective upper gastrointestinal cancer surgeries. Patients were allocated randomly into two groups (60 patients each) to receive, besides general anesthesia: continuous intra and postoperative intravenous (IV) infusion with fentanyl for 72 h postoperatively (patient controlled intravenous analgesia [PCIA] group) or continuous intra and postoperative epidural infusion with bupivacaine 0.125% and fentanyl (PCEA group) for 72 h postoperatively. Perioperative hemodynamics were recorded. Postoperative pain was assessed over 72 h using visual analog scale (VAS). All patients were screened for occurrence of myocardial injury (MI) by electrocardiography, echocardiography, and cardiac troponin I serum level. Other postoperative complications as arrhythmia, deep venous thrombosis (DVT), pulmonary embolism, pneumonia, and death were recorded.ResultsThere was a significant reduction in overall adverse cardiac events (myocardial injury, arrhythmias, angina, heart failure and nonfatal cardiac arrest) in PCEA group in comparison to PCIA group. Also, there was a significant reduction in dynamic VAS pain score in group PCEA in comparison to PCIA at all measured time points. Regarding perioperative hemodynamics, there was a significant reduction in intra-operative mean arterial pressure (MAP); and heart rate in PCEA group in comparison to PCIA group at most of measured time points while there was not a significant reduction in postoperative MAP and heart rate in the second and third postoperative days. The incidence of other postoperative complications such as DVT, pneumonia and in hospital mortality were decreased in PCEA group.ConclusionPerioperative thoracic epidural analgesia in patients suffering from coronary artery disease subjected to major abdominal cancer surgery reduced significantly postoperative major adverse cardiac events with better pain control in comparison with perioperative IV analgesia.

No abstract

Background: Pain is a common symptom in cancer patients and it is the most disturbing complications affecting the quality of life markedly. The incidence of pain depends on the type and stage of the cancer. There are many barriers that prevent treatment of cancer pain as fear of addiction, side effects and fear of distracting physicians from treating the cancer. The objective of this review is to illustrate different types, effects and various tools of the cancer pain control as well as a how to choose the ideal technique suitable for your pain. Conclusion: Cancer pain is multifactorial with complicated Pathophysiology, but early diagnosis, careful history and good assessment lead to ideal selection of treatment plane either medications or interventions accordingto WHO step ladder. interventional therapies for cancer pain include; cordotomy, myelotomy, sympathectomy, peripheral neurectomy, dorsal rhizotomy and ganglionectomy, dorsal root entry zone lesioning, and others. And, early interventional is favorable due to many reasons; avoiding central pain, general condition of patients is still good and cancer itself not metastatic everywhere.

No abstract