Abordaje guiado por ultrasonidos de los nervios intercostales en la línea media axilar para cirugía de mama no reconstructiva y de la axila

García, P. Diéguez; Pérez, Mario Fajardo; Álvarez, S. López; Torre, P. Alfaro de la; Castiñeiras, A. Pensado

doi:10.1016/j.redar.2013.04.002

Cited by 38 publications

(11 citation statements)

References 15 publications

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“…With the injection of local anaesthetic deep to serratus anterior muscle, sensory blockade up to T2 dermatome has been reported. [282930] This approach likely provides a good anterior distribution of the block, which is not achieved with the superficial approach to SPB. SPB should be supplemented with additional analgesic agent during axillary dissection, as sensory loss of T1 is seldom achieved.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy: A randomised, controlled trial

et al. 2017

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Background and Aims:Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB).Methods:This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1.5 mcg/kg, propofol 1–2 mg/kg and vecuronium 0.1 mg/kg, patients were administered either ultrasound-guided thoracic PVB at T4 (n = 25) or SPB at 5th rib (n = 25) with 20 ml of 0.5% bupivacaine, both as a single level injection. Time to first rescue analgesia and morphine consumption in 4, 6, 24, 48 and 72 h by PCA pump, visual analogue scale score and any adverse effects were recorded. Quantitative variables were compared using the unpaired t-test or the Mann–Whitney U test between the two groups. Qualitative variables were compared using the Chi-square test or Fisher's exact test.Results:The duration of analgesia (mean ± Standard deviation [SD]) was significantly longer in the PVB group compared to SPB group (346 ± 57 min vs. 245.6 ± 58 min, P < 0.001). The post-operative 24 h morphine consumption (mean ± SD) was significantly higher in the SPB group (9.7 ± 2.1 mg) compared to PVB group (6.5 ± 1.5 mg) (P < 0.001).Conclusion:Ultrasound-guided SPB is an alternative analgesic technique to thoracic PVB for MRM although PVB provides a longer duration of analgesia.

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Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy: A randomised, controlled trial

et al. 2017

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“…Previous studies have examined the analgesic effects of conventional8–9,24–26 and ultrasound-guided27,28 ICNBs in patients undergoing percutaneous nephrolithotomy,24,27 open cholecystectomy,25 breast surgery,26,28 and the Nuss procedure 8,9. They demonstrated that ICNBs could decrease pain intensity and improve the health-related quality of life in the immediate postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children

Luo

Liu²,

Li³

et al. 2017

The Clinical Journal of Pain

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Objectives:Patients experience severe pain after pectus excavatum (PE) surgery. The aim of this prospective, randomized study was to compare analgesic effects of ultrasonography-guided bilateral intercostal nerve blocks (UG-ICNBs) with those of conventional patient-controlled intravenous analgesia (PCIA) on acute pain after the Nuss procedure for PE repair in children.Methods:A prospective randomized study was performed in children with PE who were scheduled for the Nuss procedure. Participants were randomly assigned to receive either UG-ICNBs or PCIA for postoperative analgesia. Faces Pain Scale-Revised scores, opioid consumption, analgesia-associated side effects (respiratory depression, pruritus, nausea, vomiting) during the first 24 hours, and lengths of stay in the postanesthesia care unit (PACU) and hospital were recorded after the surgery.Results:Sixty-two children undergoing the Nuss procedure were enrolled in the trial. Faces Pain Scale-Revised scores were significantly decreased in the UG-ICNBs group compared with the PCIA group for up to 6 hours after surgery. The opioid doses required in the PACU and during the first 24 hours after surgery were significantly greater in the PCIA group compared with the UG-ICNBs group. Accordingly, patients in the UG-ICNBs group showed a lower incidence of analgesia-associated side effects and faster PACU discharge compared with the PCIA group.Conclusions:Our study suggests that UG-ICNBs might be more effective than PCIA for postoperative analgesia in children who undergo the Nuss procedure for PE.

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“… 12 In a study by Fernandez Martin et al on modified BRILMA block in supraumbilical open surgeries like cholecystectomy and gastrectomy, they found that the intraoperative fentanyl consumption and postoperative morphine consumption were significantly reduced following a preincisional block. 7 In various other studies, Serratus-Intercostal interfascial plane block effectively reduced the postoperative analgesic consumption in nonreconstructive breast surgeries, 3 , 4 open cholecystectomies, 5 and open gastrectomy. 6…”

Section: Discussionmentioning

confidence: 91%

“…This block has been effectively used to treat postoperative pain following breast surgeries. 3 , 4 Performed at the lower intercostal levels, this modified BRILMA block can render analgesia for upper abdominal surgeries. 5–7 There were no Randomized Controlled Trials (RCT) comparing the modified BRILMA block with Subcostal TAP block, and only very few studies are available about the modified BRILMA block to our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Randomized Controlled Trial

Saravanan

Venkatraman

Karthika

2021

LRA

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Background and Aims Subcostal Transversus Abdominis Plane (TAP) block is the standard practice for postoperative analgesia following laparoscopic cholecystectomy. This study aimed to compare the efficacy of modified BRILMA Block (blocking the BRanches of Intercostal nerves at the Level of Mid-Axillary line) with Subcostal TAP block for pain relief following laparoscopic cholecystectomy. Methods Sixty cases scheduled for laparoscopic cholecystectomy were randomly divided into two groups: modified BRILMA block (Group B) and Subcostal TAP block (Group T). General anesthesia was standardized for both groups. Blocks were performed with 20 mL of 0.2% Ropivacaine under ultrasound guidance after induction of anesthesia. Patients were administered morphine through patient controlled analgesia (PCA) pump with a bolus dose of 1 mg, 10 min lockout interval, and a basal infusion rate of 0.1 mg/h. The pain was assessed by the Visual Analog Scale (VAS) scores of one to ten. The total morphine consumption, time to first request for rescue analgesia, and VAS scores at rest and with movement, and complications, if any, were recorded. Results The morphine consumption in Group B was 5.67 ± 1.98 mg and in Group T was 5.17 ± 1.85 mg, which was found to be statistically insignificant (p-value = 0.317). The time to first request for rescue analgesia was 759.33 ± 80.29 min in Group B which was comparable to 854 ± 93.01 min in Group T and statistically insignificant (p-value = 0.295). The average VAS scores at rest as well as on movement were comparable in both the groups during the entire 24 h postoperative period. No complications were encountered in our study. Conclusion Ultrasound-guided modified BRILMA block is equally efficacious as subcostal TAP block in providing postoperative analgesia with similar morphine consumption and no significant difference in VAS scores at rest and movement following laparoscopic cholecystectomy. Trial Registration Number CTRI/2020/02/023457.

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Abordaje guiado por ultrasonidos de los nervios intercostales en la línea media axilar para cirugía de mama no reconstructiva y de la axila

Cited by 38 publications

References 15 publications

Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy: A randomised, controlled trial

Analgesic efficacy of ultrasound-guided paravertebral block versus serratus plane block for modified radical mastectomy: A randomised, controlled trial

Comparison of Ultrasonography-guided Bilateral Intercostal Nerve Blocks and Conventional Patient-controlled Intravenous Analgesia for Pain Control After the Nuss Procedure in Children

Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy – A Randomized Controlled Trial

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