Paravertebral Blocks in Breast Cancer Surgery: Is There a Difference in Postoperative Pain, Nausea, and Vomiting?

Aufforth, Rachel; Jain, Joses A.; Morreale, John; Baumgarten, Richard K.; Falk, Jeffrey; Wesen, Cheryl

doi:10.1245/s10434-011-1899-5

Cited by 40 publications

(30 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mean age of the patients was 54.1 ±2.41 (36-75). Excisional biopsy took 12.1±2.78 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) minutes and sentinel lymph node biopsy took 15.5±3.73 (10-23) minutes after local anesthesia was applied. Average time between excisional biopsy and sentinel lymph node biopsy was 27.1±3 days.…”

Section: Resultsmentioning

confidence: 99%

Surgical Treatment of Early Breast Cancer Under Local Anesthesia

Beksaç¹,

Çetin²

2019

Acta Oncol Tur.

View full text Add to dashboard Cite

Meme koruyucu cerrahinin lokal anestezi altında yapılabileceğini göstermek. YÖNTEM ve GEREÇLER: Ardışık 60 meme kanseri hastasına lokal anestezi altında meme koruyucu cerrahi uygulandı. Bütün hastalara lumpektomi ve sentinel lenf nodu biyopsisi uygulandı. Palpe edilemeyen lezyonlar tel ile işartelendi. Yapılan işlem detaylı bir şekilde açıklandı. BULGULAR: Eksizyonel biyopsi ve sentinel lenf nodu biyopsisi arası ortalama süre 27,1±3 gündü. 24 (%40) hastada telle işaretli biyopsi gerekli oldu. 51 (%85) hastada cerrahi lokal anestezi altında tamamlandı. 9 (%15) hastada sentinel lenf nodu biyopsisi tümör-pozitifti. Bu hastalara genel anestezi altında aksilla diseksiyonu yapıldı. Hiçbir hastanın lokal anesteziye intoleransı olmadı. TARTIŞMA ve SONUÇ: Lokal anestezi altında bariz bir şekilde hasta konforu sağladı. Bu sayede hastalar günübirlik cerrahide tedavi oldular ve genel anestezinin yan etkilerinden ve ekstra maliyetten kaçınılmış olundu. Bizim sonuçlarımız tekniğin yapılabilirliğinin güzel bir göstergesidir. Anahtar Kelimeler: Meme kanseri, meme koruyucu cerrahi, lokal anestezi, sentinel lenf nodu ABSTRACT INTRODUCTION: To show the viability of breast-conserving surgery under local anesthesia. MATERIAL and METHODS: 60 consecutive breast cancer patients treated with breast-conserving surgery under local anesthesia are reported in this study. Wide excisional biopsy and sentinel lymph node biopsy were performed in all patients. Wire-guided biopsy method was used in non-palpable lesions. Techniques used are described in detail. RESULTS: Average time between excisional biopsy and sentinel lymph node biopsy was 27.1±3 days. Wireguided excisional biopsy was the method of choice in 24 (40%) patients. In 51 of 60 (85%) patients, surgery was completed under local anesthesia. 9 (15%) patients' sentinel lymph node biopsy result was tumour-positive. These patients required axillary dissection under general anesthesia. None of the patients showed intolerance to surgery under local anesthesia. DISCUSSION AND CONCLUSION: Surgery under local anesthesia provides significantly better patient comfort as the patients can be handled in the outpatient clinic. Local anesthesia is free of side effects and extra costs of general anesthesia are avoided. Our report is a good addition to the literature supporting the viability of the technique.

show abstract

Section: Resultsmentioning

confidence: 99%

Surgical Treatment of Early Breast Cancer Under Local Anesthesia

Beksaç¹,

Çetin²

2019

Acta Oncol Tur.

View full text Add to dashboard Cite

show abstract

“…While unilateral PVBs are relatively commonplace, despite their demonstrated efficacy in various anatomic regions, bilateral PVBs are not commonly used—their popularity has potentially been limited by the theoretical risk of bilateral pneumothorax . Consequently, while unilateral PVBs are commonly used in breast surgery, few studies have explored the use of bilateral PVBs . The purpose of this work was to evaluate the feasibility of using bilateral TPVBs in outpatient surgery for patients undergoing bilateral mastectomy with immediate implant‐based reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of bilateral thoracic paravertebral blocks in outpatient breast surgery

2018

View full text Add to dashboard Cite

Unilateral thoracic paravertebral blocks (TPVBs) have demonstrated reliable intraoperative analgesia, low postoperative pain scores, and an opioid-sparing effect in breast cancer surgery. However, secondary to the perceived risk of complications, bilateral TPVB have been less well accepted and are less frequently used. The purpose of this study was to evaluate the feasibility of using bilateral TPVBs in outpatient surgery for patients undergoing bilateral mastectomy with immediate implant-based reconstruction. Electronic medical records were retrospectively reviewed for patients receiving bilateral TPVBs for bilateral mastectomy with immediate implant-based reconstruction performed by a single surgeon from September 2012 to September 2015. Records were reviewed for incidence of complications, time to discharge, and incidence of unplanned admission or readmission. Clopper-Pearson method for binomial distribution was used to calculate confidence intervals for proportions. Forty-five patients undergoing bilateral mastectomy with immediate reconstruction received bilateral TPVBs. There were 4 TPVB-related complications, all of which were symptomatic hypotension or bradycardia (9%; 95% CI, 2%-21%). There was no incidence of symptomatic pneumothorax. Mean time to discharge readiness from the postanesthesia care unit (PACU) was 1.9 hours (SD = 1.0). Overall, 91% (n = 29) of the 32 patients scheduled for day surgery were discharged home as planned. Mean time from entry to PACU to home discharge for day surgery patients (n = 32) and planned admissions (n = 13) was 5.9 hours (SD = 4.3) and 16.3 hours (SD = 3.6), respectively. There was no incidence of readmission following discharge. Bilateral TPVBs can safely facilitate day surgery in carefully selected patients undergoing bilateral mastectomy with immediate implant-based reconstruction.

show abstract

“…In a large observational single institution study patients with breast surgery not undergoing early reconstructive surgery, no differences in nausea, vomiting and postoperative pain scores were observed (Aufforth et al 2012). However hospital charts of patients were retrospectively analysed.…”

Section: Discussionmentioning

confidence: 99%

Continuous paravertebral block for postoperative pain compared to general anaesthesia and wound infiltration for major oncological breast surgery

et al. 2014

View full text Add to dashboard Cite

We hypothesized that improved acute postoperative pain relief will be achieved using general anaesthesia (GA) either in combination with continuous thoracic paravertebral block (GA-cPVB) or single shot (GA-sPVB) as compared to GA supplemented by local wound infiltration (GA-LWI) after unilateral major breast cancer surgery.A randomised controlled trial was conducted in 46 adult women in a day-care or short-stay hospital setting after major breast cancer surgery. Pain-intensity was measured using an 11-point visual analogue scale (VAS) until postoperative day 2. GA-sPVB was stopped due to slow inclusion.No significant difference in VAS score was noted between GA-LWI (VAS median 0.5 (interquartile range 0.18–2.00)) and GA-cPVB, (VAS 0.3 (0.00–1.55, p = 0.195)) 24 hours after surgery or at any point postoperatively until postoperative day 2.We conclude that both GA-LWI and GA-cPVB anaesthetic techniques are equally effective in treatment of acute postoperative pain after major oncological breast surgery. As GA-LWI is easily to perform with fewer complications and it is more cost-effective it should be preferred over GA-cPVB.

show abstract

Paravertebral Blocks in Breast Cancer Surgery: Is There a Difference in Postoperative Pain, Nausea, and Vomiting?

Cited by 40 publications

References 12 publications

Surgical Treatment of Early Breast Cancer Under Local Anesthesia

Surgical Treatment of Early Breast Cancer Under Local Anesthesia

Efficacy and safety of bilateral thoracic paravertebral blocks in outpatient breast surgery

Continuous paravertebral block for postoperative pain compared to general anaesthesia and wound infiltration for major oncological breast surgery

Contact Info

Product

Resources

About