Analgesic efficacy of modified pectoral block plus serratus plane block in breast augmentation surgery: A randomised, controlled, triple-blind clinical trial

Sala‐Blanch, Xavier; Cohen, A.P. Sánchez; López-Pantaleon, L.A.; Cubero, M.

doi:10.1016/j.redare.2018.08.010

Cited by 13 publications

(23 citation statements)

References 34 publications

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“… 72 BA ? Local infiltration Schuitemaker et al , [ 26 ] 2019 DB-RCT Spain,? 30 BA GA Pecs II + SPB C. BREAST REDUCTION Christie et al , [ 27 ] 2017 DB-RCT US, 1 40 BR GA Tumescent Anaesthesia Valente et al , [ 28 ] 2014 DB-RCT Brazil,?…”

Section: Resultsmentioning

confidence: 99%

“…The surgical procedures performed in the reviewed trials included lumpectomy or mastectomy in 14 of 19 trials [ 10 – 23 ], with additional Sentinel Lymph Node Biopsy (SLNB) or Axillary Lymph Node Dissection (ALND) [ 10 , 12 , 14 – 18 , 20 , 21 , 23 ]. Three trials included patients undergoing breast augmentation [ 24 – 26 ], and two trials also included patients undergoing breast reduction [ 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…Regional anesthetic techniques were performed in two studies: PVB in Gardiner et al [ 24 ] ; association of Pecs type II and PSB in Schuitemaker et al [ 26 ] . In the other study, Picard et al [ 25 ] , a local infiltration was performed.…”

Section: Resultsmentioning

confidence: 99%

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What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

et al. 2020

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Background Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently used anaesthetic technique. Various locoregional anesthetic techniques are also used for breast surgeries. A systematic review of the use of locoregional anesthesia for postoperative pain in breast surgery is needed to clarify its role in pain management. Objectives To systematically review literature to establish the efficacy and the safety of locoregional anesthesia used in the treatment of pain after breast surgery. Methods Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in Mars 2020 for studies examining locoregional anesthesia for management of pain in adults after breast surgery. The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively. Results Nineteen studies evaluating locoregional anesthesia were included: 1058 patients underwent lumpectomy/mastectomy, 142 breast augmentation and 79 breast reduction. Locoregional anesthesia provides effective anesthesia and analgesia in the perioperative setting, however no statistically significant difference emerged if compared to other techniques. For mastectomy only, the use of locoregional techniques reduces pain in the first hour after the end of the surgery if compared to other procedures (p = 0.02). Other potentially beneficial effects of locoregional anesthesia include decreased need for opioids, decreased postoperative nausea and vomiting, fewer complications and increased patient satisfaction. All this improves postoperative recovery and shortens hospitalization stay. In none of these cases, locoregional anesthesia was statistically superior to other techniques. Conclusion The results of our review showed no differences between locoregional anesthesia and other techniques in the management of breast surgery. Locoregional techniques are superior in reducing pain in the first hour after mastectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

et al. 2020

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“…The surgical procedures performed in the reviewed trials included lumpectomy or mastectomy in 14 of trials, [10][11][12][13][14][15][16][17][18][19][20][21][22][23] with additional Sentinel Lymph Node Biopsy (SLNB) or Axillary Lymph Node Dissection (ALND). 10, 12, 14-18, 20-21, 23 Three trials included patients undergoing breast augmentation, [24][25][26] and two trials also included patients undergoing breast reduction. [27][28] The 19 randomized controlled trials involved a total of 1307 patients, of which 749 received nerve blocks, 330 received local in ltration, 115 received IV lidocaine, 73 received infusion of local anesthetic via pump, and 40 received tumescent anesthesia.…”

Section: Resultsmentioning

confidence: 99%

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction.

Sansone

Giaccari

Faenza

et al. 2020

Preprint

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Background: Breast surgery in the United States is common. Pain affects up to 50% of women undergoing breast surgery and can interfere with postoperative outcomes. General anesthesia is the conventional, most frequently used anaesthetic technique. Various locoregional anesthetic techniques are also used for breast surgeries. A systematic review of the use of locoregional anesthesia for postoperative pain in breast surgery is needed to clarify its role in pain management.Objectives: To systematically review literature to establish the efficacy and the safety of locoregional anesthesia used in the treatment of pain after breast surgery.Methods: Embase, MEDLINE, Google Scholar and Cochrane Central Trials Register were systematically searched in Mars 2020 for studies examining locoregional anesthesia for management of pain in adults after breast surgery. The methodological quality of the studies and their results were appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and specific measurement properties criteria, respectively.Results: Nineteen studies evaluating locoregional anesthesia were included: 1058 patients underwent lumpectomy/mastectomy, 142 breast augmentation and 79 breast reduction. Locoregional anesthesia provides effective anesthesia and analgesia in the perioperative setting, however no statistically significant difference emerged if compared to other techniques. For mastectomy only, the use of locoregional techniques reduces pain in the first hour after the end of the surgery if compared to other procedures (p = 0.02). Other potentially beneficial effects of locoregional anesthesia include decreased need for opioids, decreased postoperative nausea and vomiting, fewer complications and increased patient satisfaction. All this improves postoperative recovery and shortens hospitalization stay. In none of these cases, locoregional anesthesia was statistically superior to other techniques.Conclusion: The results of our review showed no differences between locoregional anesthesia and other techniques in the management of breast surgery. Locoregional techniques are superior in reducing pain in the first hour after mastectomy.

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“…Literatür incelendiğinde, bu çalışmaya benzer şekilde SPB'u klinisyenlerce rekonstrüktif meme cerrahileri veya mastektomi cerrahilerinde ameliyat sırasında ve sonrasında analjezi amacına ek olarak meme kanserine sekonder ağrılar veya nöropatik ağrılar için de kullanılmıştır (14) . Ayrıca bu çalışmaların birçoğunda SPB'nin yanına PECS I, PECS II, paravertebral blok eklenmiş ve analjezik etkinliklerinin yeterli olduğu gösterilmiştir (15) .…”

Section: Gereç Ve Yöntemunclassified

The Effect of Ultrasound Guided Superficial Serratus Plane Block For Acute Post mastectomy Pain After Modified Radical Mastectomy and Axillary Lymph Node Dissection: A Randomized Controlled Study

Yayık¹,

Ahişkalıoğlu²,

Sulak³

et al. 2019

JARSS

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Meme kanseri kadınları etkileyen en yaygın kanser türüdür. Her yıl binlerce hasta meme ve aksiller bölgeden cerrahi geçirmektedir. Bu cerrahi sırasında çok ciddi akut postoperatif ağrı meydana gelmektedir. Ultrasonografini kullanımının son yıllarda rejyonal anestezi pratiğinde artmasıyla birlikte plan blokları da oldukça popüler hale gelmiştir. Bunlardan birisi de serratus kasının üzerine veya altına lokal anestezik yayılımı ile tanımlanan serratus plane bloğudur (SPB). Bu çalışmanın amacı, meme kanseri nedeniyle modifiye radikal mastektomi ve lenf nodu diseksiyonu yapılacak hastalarda yüzeyel SPB'nun postoperatif opioid tüketimine etkisini araştırmaktır. Yöntem: Etik onam alındıktan sonra 18-65 yaş arası, ASA I-III modifiye radikal mastektomi ve aksiller lenf nodu diseksiyonu yapılacak olan 48 hasta randomize olarak serratus blok (grup SPB, n=24) veya kontrol grubu (grup K, n=24) olarak 2 gruba ayrıldı. SPB grubuna ultrasound eşliğinde 30 mL %0.25'lik bupivakain serratus kası üzerine SPB uygulandı. Grup K'ya ise ultrasound eşliğinde 2 mL salin subkutan cerrahi öncesi uygulandı. Postoperatif dönemde 12 saatte bir 50 mg deksketoprofen trometamol ve intravenöz fentanil ile hasta kontrollü analjezi düzenlendi. Aktif ve pasif visual analog skala (VAS) ile postoperatif analjezi değerlendirildi. Opioid tüketimi, ek analjezi gereksinimi ve opioid ile ilişkili yan etkiler ilk 24 saatte kaydedildi. Bulgular: SPB grubu 24 saatlik fentanil tüketimi açısından kontrol grubundan anlamlı olarak daha düşük bulunmuştur (123.96±72.04 vs 345.83±207.56 sırasıyla p<0.001). Hastaların postoperatif tüm ölçüm zamanlarında VAS değerleri Grup SPB'de kontrol grubuna göre anlamlı derecede düşüktü (p<0.05). Ek analjezik gereksinimi; Grup SPB'de kontrol grubuna göre anlamlı derecede düşüktü (3/24 vs 9/24 sırasıyla p=0.046). Sonuç: Yüzeyel SPB; modifiye radikal mastektomi ve lenf nodu diseksiyonu cerrahisinde kolay uygulanabilir olması, kusursuz bir analjezi sağlaması ve opioid tüketimini azaltmasıyla postoperatif ağrı yönetimi için güvenle kullanılabilir.

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Analgesic efficacy of modified pectoral block plus serratus plane block in breast augmentation surgery: A randomised, controlled, triple-blind clinical trial

Cited by 13 publications

References 34 publications

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction

What is the role of locoregional anesthesia in breast surgery? A systematic literature review focused on pain intensity, opioid consumption, adverse events, and patient satisfaction.

The Effect of Ultrasound Guided Superficial Serratus Plane Block For Acute Post mastectomy Pain After Modified Radical Mastectomy and Axillary Lymph Node Dissection: A Randomized Controlled Study

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