Efficacy Of Erector Spinae Plane Block For Postoperative Analgesia In Breast Cancer Surgery A Randomized Controlled Trial

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EFFICACY OF ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN BREAST CANCER SURGERY: A RANDOMIZED CONTROLLED TRIAL

Author : Gurpreet Singh
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis EFFICACY OF ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN BREAST CANCER SURGERY: A RANDOMIZED CONTROLLED TRIAL by : Gurpreet Singh

Download or read book EFFICACY OF ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN BREAST CANCER SURGERY: A RANDOMIZED CONTROLLED TRIAL written by Gurpreet Singh and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims: Women undergoing breast cancer surgery often experience severe post-operative pain and may develop chronic postoperative pain. This study was conducted to evaluate the analgesic efficacy of erector spine plane (ESP) block for postoperative analgesia in breast cancer surgery. The primary outcome of this study was 24 hour morphine consumption and secondary outcomes were pain scores and adverse effects.Methods: After institutional ethics committee approval (reference no. NK/3870/MD/339 dated September 21, 2016)(CTRI/2018/03/012307), 60 ASA I or II patients aged 18-60 years, scheduled for elective breast cancer surgery were randomly allocated in to either ESP group or control group. Ultrasound (US)-guided ESP block with 0.4ml/kg of 0.5% ropivacaine at the T5 vertebral level was performed preoperatively in ESP group. Patient-controlled morphine analgesia was used for postoperative pain relief in both the groups. Postoperatively patients were assessed for pain using NRS score at fixed time intervals for 24 hours, time for first rescue analgesia and total analgesic consumption in first 24 hrs were noted. Results: 24 hour morphine consumption in the ESP group decreased by 42% compared to the control group (2.9u00b1 2.5 mg vs 5.0 u00b1 2.1 mg) (P- 0.01). The NRS score was significantly lower in ESP group at all intervals up to 6 hours of surgery (p

1 - ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK REDUCES POSTOPERATIVE OPIOID CONSUMPTION FOLLOWING BREAST SURGERY: A RANDOMIZED CONTROLLED STUDY.

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 1 - ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK REDUCES POSTOPERATIVE OPIOID CONSUMPTION FOLLOWING BREAST SURGERY: A RANDOMIZED CONTROLLED STUDY. by :

Download or read book 1 - ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK REDUCES POSTOPERATIVE OPIOID CONSUMPTION FOLLOWING BREAST SURGERY: A RANDOMIZED CONTROLLED STUDY. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: PurposePostoperative analgesia in breast surgery is a difficult and overworked issue due to extensive surgery and complex innervation of the breast. Erector spinae plane block (ESB) is a new defined regional anesthesia technique for thoracic analgesia. Although there are some case reports about ESB in breast surgeries, there is no published randomized controlled study in the literature about ESB use for this purpose. Main purpose of this study was to evaluate the analgesic effect of ultrasound guided ESB in breast surgery.MethodsFifty ASA I-II female patients, aged 25-65, who were scheduled to go under elective breast surgery were included to the study. Patients were randomized into two group as ESB and Control group. Single shot ultrasound (US) guided ESB with 20ml 0.25 % bupivacaine was done preoperatively to all patients in ESB group. Patients in both groups were provided with iv patient controlled analgesia device containing morphine for the postoperative analgesia. Morphine consumptions and visual analogue scale (VAS) scores for pain were recorded at 1st,6th, 12th and 24th hours postoperatively. ResultsThere were no significant differences between ESB and control groups for VAS scores at 1st, 6th, 12th and 24th hour (Median VAS values were 2, 2, 0, 0, and 2, 2, 1, 1 respectively). Postoperative morphine consumptions were significantly lower in ESB group compared to control group at postoperative 1st, 6th, 12th, 24th hour (Median doses of morphine consumptions were 1, 2, 3, 5 and 1, 5, 10, 16 mg respectively) (p

1 - COMPARISON OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AND THORACIC PARAVERTEBRAL BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VIDEO-ASSISTED THORACIC SURGERY: A PROSPECTIVE RANDOMIZED NON-INFERIORITY TRIAL

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Author : Taro Fujitani
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 1 - COMPARISON OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AND THORACIC PARAVERTEBRAL BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VIDEO-ASSISTED THORACIC SURGERY: A PROSPECTIVE RANDOMIZED NON-INFERIORITY TRIAL by : Taro Fujitani

Download or read book 1 - COMPARISON OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK AND THORACIC PARAVERTEBRAL BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VIDEO-ASSISTED THORACIC SURGERY: A PROSPECTIVE RANDOMIZED NON-INFERIORITY TRIAL written by Taro Fujitani and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and aims: The anesthetic characteristics of ultrasound-guided erector spinae plane block (ESPB) remain unclear. We conducted a study to clarify the analgesic efficacy of ESPB compared to that of thoracic paravertebral block (TPVB) for postoperative analgesia in video-assisted thoracic surgery (VATS).Methods: This study was a prospective randomized non-inferiority trial approved by the Institutional Review Board of Ehime Prefectural Central Hospital (No. 29-84, 02/03/2018). Eighty-eight patients scheduled for VATS were randomly allocated to either an ESPB or a TPVB group. Patients in both groups received continuous infusion of 0.2% levobupivacaine (8 mL/hour) after 20 mL of 0.2% levobupivacaine bolus injection. The primary outcome was postoperative numerical pain rating score (NRS) at rest 24 hours postoperatively, with a maximum acceptable difference (non-inferiority margin) between the groups as 1. We also evaluated NRS during movement, amount of rescue fentanyl used, and anesthetized dermatome number.Results: Eighty-one patients completed the study. NRS at rest was significantly lower in the TPVB group at 1, 2, and 24 hours postoperatively (respective p values = 0.018, 0.008, and 0.030). There were no significant differences in NRS during movement. The median difference in NRS at rest 24 hours postoperatively was over 1, which failed to demonstrate non-inferiority. The number of anesthetized dermatomes at parasternal regions was significantly greater in the TPVB group (p

Continuous Erector Spinae Plane Block in Breast Cancer Surgery

Author : Pamela Maru00eda Clusella
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Continuous Erector Spinae Plane Block in Breast Cancer Surgery by : Pamela Maru00eda Clusella

Download or read book Continuous Erector Spinae Plane Block in Breast Cancer Surgery written by Pamela Maru00eda Clusella and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and AimsErector spinae plane (ESP) block has recently been reported for thoracic wall procedures. We describe three cases of continuous ESP block in breast cancer surgery. MethodsThree patients (37, 42, and 47 years-old) underwent breast cancer surgery (mastectomy and sentinel lymph node dissection, mastectomy and lymphadenectomy and tumorectomy and lymphadenectomy, respectively). ESP block was performed at T2 level with ropivacaine 0.35% (30 mL) plus catheter insertion with sedation with midazolam. General anesthesia was maintained with propofol (7mg/Kg/h) and low-dose remifentanil (0.05 mcg/Kg/minute). A single dose of fentanyl (2 mcg/Kg) was used in the induction. All patients received intraoperative antiemetic prophylaxis, dexketoprofen and paracetamol. Continuous ESP block with ropivacaine 0.2% infusion (10mL/h), paracetamol and dexketoprofen were administered for postoperative pain control. Pain was measured with VAS score (0-10) when patients arrived at the post-anesthesia care unit (PACU), when they left PACU and 24 hours after surgery. ResultsPatients reported VAS of 0-1 at all endpoints without requiring any additional analgesia. After ESP catheter infusion was stopped the analgesia lasted 6-8 hours. ConclusionsESP block provides anesthesia at multi-dermatomal levels across posterior, lateral and anterior thoracic wall, making this technique suitable for breast cancer surgery. The main advantage of this block is that it may cover a greater area of the breast and the axilla. Continuous infusion ensures optimal postoperative pain control. In conclusion, we present 3 cases of complex breast cancer surgery where continuous ESP block led to an optimal perioperative pain control with a minimum use of opioids and other analgesics.

Continuous Erector Spinae Plane Block in Breast Cancer Surgery

Author : Pamela Maria Celdrán-Clusella
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (134 download)

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Book Synopsis Continuous Erector Spinae Plane Block in Breast Cancer Surgery by : Pamela Maria Celdrán-Clusella

Download or read book Continuous Erector Spinae Plane Block in Breast Cancer Surgery written by Pamela Maria Celdrán-Clusella and published by . This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and AimsErector spinae plane (ESP) block has recently been reported for thoracic wall procedures. We describe three cases of continuous ESP block in breast cancer surgery. MethodsThree patients (37, 42, and 47 years-old) underwent breast cancer surgery (mastectomy and sentinel lymph node dissection, mastectomy and lymphadenectomy and tumorectomy and lymphadenectomy, respectively). ESP block was performed at T2 level with ropivacaine 0.35% (30 mL) plus catheter insertion with sedation with midazolam. General anesthesia was maintained with propofol (7mg/Kg/h) and low-dose remifentanil (0.05 mcg/Kg/minute). A single dose of fentanyl (2 mcg/Kg) was used in the induction. All patients received intraoperative antiemetic prophylaxis, dexketoprofen and paracetamol. Continuous ESP block with ropivacaine 0.2% infusion (10mL/h), paracetamol and dexketoprofen were administered for postoperative pain control. Pain was measured with VAS score (0-10) when patients arrived at the post-anesthesia care unit (PACU), when they left PACU and 24 hours after surgery. ResultsPatients reported VAS of 0-1 at all endpoints without requiring any additional analgesia. After ESP catheter infusion was stopped the analgesia lasted 6-8 hours. ConclusionsESP block provides anesthesia at multi-dermatomal levels across posterior, lateral and anterior thoracic wall, making this technique suitable for breast cancer surgery. The main advantage of this block is that it may cover a greater area of the breast and the axilla. Continuous infusion ensures optimal postoperative pain control. In conclusion, we present 3 cases of complex breast cancer surgery where continuous ESP block led to an optimal perioperative pain control with a minimum use of opioids and other analgesics.

Ultrasound-guided Erector Spinae Plane (US- ESP) Block Associated to Dexmetomidine Cooperative Sedation for Anesthetic Management in Breast Cancer Surgery: a Case Report

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Author : Giordano Carolina
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Ultrasound-guided Erector Spinae Plane (US- ESP) Block Associated to Dexmetomidine Cooperative Sedation for Anesthetic Management in Breast Cancer Surgery: a Case Report by : Giordano Carolina

Download or read book Ultrasound-guided Erector Spinae Plane (US- ESP) Block Associated to Dexmetomidine Cooperative Sedation for Anesthetic Management in Breast Cancer Surgery: a Case Report written by Giordano Carolina and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:Ultrasound-guided Erector Spinae Plane Block (US-ESPB) is a recently described regional block technique for anesthesia and analgesia of the chest wall. Dexmetomidine (DEX) is an u03b1-2 agonist that can provide cooperative sedation during surgery. We reported a case of US-ESPB associated to intraoperative DEX sedation in a patient undergoing breast cancer surgery.Methods:A 42 years-old patient, ASA 2, was scheduled to undergo quadrantectomy with sentinel lymph node biopsy. Before surgery, we performed a US-ESPB and 20 ml of 0,5% Ropivacaine were injected using a 90 mm needle (Temena u00ae) deep to the erector spinae muscle and superficial to T5 transverse processes. The patient received intravenously DEX in a loading dose of 1 mcg/kg over 15 minutes, followed by an infusion of 0,4 mcg/kg/h and oxygen (4 l/min) was administered by facemask.Results:We obtained adequate surgical anesthesia and a good quality postoperative analgesia. Moreoverer, DEX infusion provided cooperative sedation during surgery (Ramsay 3) without causing respiratory depression of the patient. Only 3 g of acetaminophen were administered postoperatively. No complications were recorded.Conclusions:This case report suggested that US-ESPB associated to intraoperative DEX cooperative sedation could represent a reliable strategy for anesthetic management in breast surgery.

ERECTOR SPINAE PLANE BLOCK FOR BREAST CANCER SURGERY. A CASE SERIES.

Author : Mu00f3nica Pu00e9rez Poquet
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK FOR BREAST CANCER SURGERY. A CASE SERIES. by : Mu00f3nica Pu00e9rez Poquet

Download or read book ERECTOR SPINAE PLANE BLOCK FOR BREAST CANCER SURGERY. A CASE SERIES. written by Mu00f3nica Pu00e9rez Poquet and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:Postoperative pain for breast cancer surgery (BCS) can be managed with regional anaesthesia. Erector spinae plane (ESP) block has been recently described for thoracic surgery. The aim of this study is to evaluate postoperative pain in BCS after performing ESP block. We also recorded opioid consumption, incidence of postoperative nausea and vomiting (PONV) and length of stay (LOS).Methods:We retrospectively analysed patients who underwent BCS with general anaesthesia and ESP block for postoperative pain management between October 2017 and April 2018. US-guided ESP block by a single puncture at T5 level with minimal sedation was performed. We administered levobupivacaine 0.3% (30mL) as local anaesthetic. Afterwards, the patient received a total intravenous anaesthesia. Moreover, all patients received intraoperatively dexketoprophen and paracetamol and antiemetic prophylaxis.ResultsWe recorded data from 16 women: 3 patients underwent mastectomy and 13 tumorectomy plus sentinel lymph node biopsy. Median VAS scores were 1.56 (0-5) at PACU, 0.25 (0-2) after PACU and 0.27 (0-3) 24h after surgery. Five patients needed minor opioids at PACU. None of them needed major opioids. One patient had PONV. Median LOS was 1.25 days.Conclusions:Postoperative VAS scores in patient who underwent ESP block were low. In our experience, ESP block provides good postoperative analgesia in BCS. Patients rarely needed opioids, had low incidence of PONV and short LOS.

ERECTOR SPINAE PLANE BLOCK (ESP) FOR POSTOPERATIVE ANALGESIA FOR MASTECTOMY TOTAL RADICAL: CASE REPORT

Author : Rueda Viviana
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK (ESP) FOR POSTOPERATIVE ANALGESIA FOR MASTECTOMY TOTAL RADICAL: CASE REPORT by : Rueda Viviana

Download or read book ERECTOR SPINAE PLANE BLOCK (ESP) FOR POSTOPERATIVE ANALGESIA FOR MASTECTOMY TOTAL RADICAL: CASE REPORT written by Rueda Viviana and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: To describe 50-year-old female patient, , a weight of 62 kg, with an 8-year history of a mass in the right breast which has undergone rapid progressive growth, involving the entire breast, over the past 7 months, diagnosed as a phyllodes tumor. Simple right mastectomy with axillary lymph node dissection and pectoralis major fascia resection were performed under general anesthesia. Ultrasound-guided erector spinae plane block was performed for postoperative analgesia, with excellent response up to 18 hours following the procedure.The patient was placed on left lateral decubitus and, following asepsia and anti-sepsis, T6 to T7 and right paravertebral ultrasound was performed using a highfrequency linear probe, to identify the anatomy (Figure 2) Bupivacaine with 0.25% epinephrine and 0.5% lidocaine was administered (total volume 20mL), achieving satisfactory erector spinae hydrodissection. Assessment 4hours later found an area of anesthesia comprised by the right anterior hemithorax and axillary region and anesthesia from T4 to T12 in the posterior region (Figure 3) Pain assessment was performed over a 30-hour period using the analog visual scale. Based on our findings, ESP block may be recommendedas an option or adjunct for pain management.

THE ERECTOR SPINAE PLANE BLOCK AS AN ANALGESIC REGIONAL TECHNIQUE IN ACUTE POST-SURGICAL PAIN CONTROL IN LUMBAR SURGERY. PRELIMINARY FINDINGS OF A RANDOMIZED TRIAL

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Author : MARTINA VENTIMIGLIA
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis THE ERECTOR SPINAE PLANE BLOCK AS AN ANALGESIC REGIONAL TECHNIQUE IN ACUTE POST-SURGICAL PAIN CONTROL IN LUMBAR SURGERY. PRELIMINARY FINDINGS OF A RANDOMIZED TRIAL by : MARTINA VENTIMIGLIA

Download or read book THE ERECTOR SPINAE PLANE BLOCK AS AN ANALGESIC REGIONAL TECHNIQUE IN ACUTE POST-SURGICAL PAIN CONTROL IN LUMBAR SURGERY. PRELIMINARY FINDINGS OF A RANDOMIZED TRIAL written by MARTINA VENTIMIGLIA and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND AND AIM: Inadequate pain control affects morbidity and hospitalization length. Post-operative pain is commonly managed with opioids with important side effect. Recent data has shown that the novel erector spinae plane (ESP) block, can be employed as a safe regional analgesic technique for acute post-surgical and chronic neuropathic pain.The aim of the present study was to investigate the capacity of ESP block to provide successful post-operative pain management undergoing spinal surgery. METHODS: 29 patients undergoing open lumbar decompression surgery were randomized in two groups. ESP group (n=12) received ESP block with 0,5% levobubivacaina 20 ml, the control group (n=17) no intervention was performed and postoperative analgesia was achieved with IV morphine plus ketorolac. The primary outcome was represented by postoperative numerical rate scale (NRS) score at various time periods during the first 24 hours following surgery. The secondary outcomes included opioid consumption, rescue analgesia and opioid related side effects. The study protocol was approved by the local review board. RESULTS: Compared with control group, the NRS score of ESP block patients did not show any statistically significant differences in the measured time periods. Twenty-four-hour opioid consumption in group control was significantly higher compared to group ESP (30u00b12.6 mg and 10u00b12.08 mg, p

4 - PECS VERSUS ERECTOR SPINAE BLOCK FOR BREAST SURGERIES: A RANDOMISED CONTROLLED TRIAL.

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 4 - PECS VERSUS ERECTOR SPINAE BLOCK FOR BREAST SURGERIES: A RANDOMISED CONTROLLED TRIAL. by :

Download or read book 4 - PECS VERSUS ERECTOR SPINAE BLOCK FOR BREAST SURGERIES: A RANDOMISED CONTROLLED TRIAL. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Patients undergoing breast cancer surgeries face significant post-operative pain. Achieving adequate perioperative analgesia can be challenging. Materials and Method: this prospective randomised study was done over a period of 8 months. 60 ASA I/II patients undergoing unilateral MRM were included in this study. Patients in Grp I received PECS block, while in Grp II received ES blockAssessment: Preoperative sensory blockade, postoperative pain relief and analgesic requirement were noted.Results: Patients in PECS group had better pain control and lesser analgesic requirement postoperatively.Conclusion: Pecs Block is a more effective block than ES in terms of analgesia and opioid consumption.

ERECTOR SPINAE PLANE BLOCK AS PART OF AN OPIOID-SPARING ANAESTHETIC STRATEGY FOR BREAST QUADRANTECTOMY AND SENTINEL LYMPH-NODE EXCISION: A CASE-REPORT

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Author : Lopes Luis
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis ERECTOR SPINAE PLANE BLOCK AS PART OF AN OPIOID-SPARING ANAESTHETIC STRATEGY FOR BREAST QUADRANTECTOMY AND SENTINEL LYMPH-NODE EXCISION: A CASE-REPORT by : Lopes Luis

Download or read book ERECTOR SPINAE PLANE BLOCK AS PART OF AN OPIOID-SPARING ANAESTHETIC STRATEGY FOR BREAST QUADRANTECTOMY AND SENTINEL LYMPH-NODE EXCISION: A CASE-REPORT written by Lopes Luis and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:Breast surgery often requires post-operative opioid analgesia, which has been associated with treatment-resistant chronic pain syndromes, and been suggested as having cancer-spreading potential. Erector spinae plane (ESP) block is a novel approach to thoracic and abdominal pain management which has previously been described as successfully implemented perioperatively in various breast interventions. We hereby present our experience in the management of a quadrantectomy patient.Methods:An otherwise healthy 66-year old woman presented for right-lower quadrantectomy of the right breast with sentinel lymph node excision. An anaesthetic management plan consisting of combined general anaesthesia with right-sided ESP block was devised. Ultrasonography-guided injection of 20cc of 0,75% ropivacaine along the erector spinae fascial plane at the T5 spinal level was performed preoperatively. General anaesthesia was induced with fentanyl (100mcg) and propofol (120mg). After supraglottic device placement, maintenance was ensured with sevoflurane. Additional intravenous analgesia was provided with paracetamol(1g) and ketorolac(30mg). ResultsHaemodynamic stability was noted throughout surgery, with no response to skin incision or tissue dissection. The patient reported no significant pain upon waking or discharge, 24h later. No rescue analgesia was needed during that period and skin numbness representing no significant discomfort subsided over the next day.Conclusions:Our report of a successful implementation of nearly opioid-free anaesthesia in a quadrantectomy patient, by using the novel potential of the ESP-block, suggests that this might be an invaluably safe and effective strategy, not only for pain control, but also as an opioid and anaesthetic-sparing approach, plausibly increasingly useful in debilitated and physiologically fragile patients.

The Ultrasound-guided Erector Spinae Plane Block Allows Opioid Free Anesthesia in the Modified Radical Mastectomy with Axillary Dissection: a Pilot Study about 14 Cases

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Author : El Ahmadi Brahim
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis The Ultrasound-guided Erector Spinae Plane Block Allows Opioid Free Anesthesia in the Modified Radical Mastectomy with Axillary Dissection: a Pilot Study about 14 Cases by : El Ahmadi Brahim

Download or read book The Ultrasound-guided Erector Spinae Plane Block Allows Opioid Free Anesthesia in the Modified Radical Mastectomy with Axillary Dissection: a Pilot Study about 14 Cases written by El Ahmadi Brahim and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:the modified radical mastectomy with axillary dissection is usually carried out under balanced general anesthesia using opiates, it is a source of moderate to severe postoperative acute pain. Opioid-free anesthesia (OFA) aims to reduce the undesirable effects of opioids while ensuring optimal anesthesia and analgesia perioperatively. we report 14 cases of ultrasound-guided Erector Spinae Plane Block (ESPB) to perform surgery using OFA.Methods:We recruited patients presenting no contraindications to the anesthetic technique. The OFA protocol included a general anesthesia with no opioids and an ultrasound-guided erector spinae plane block with bupivacaine at T4 level. Prior to incision, patients received a bolus of Ketamine, Ketoprofen, dexamethasone IV . Maintenance of anesthesia was performed by sevoflurane at 1 MAC. In case of haemodynamic repercussions related to nociception, a bolus of fentanyl at 1 u03bcg / kg was administered.ResultsAfter the approvel of the ethic comitee we included 14 consenting patients. Hemodynamic variations were all less than 20% of baseline. No patient had any intraoperative opiate injection. Upon waking, patients had a median visual analogical scale (VAS) less than 3. During the first 24 hours, the VAS was less than 3. Only one patient received a bolus of 3 mg morphine IV as part of the catch-up postoperative analgesia. After 24 h, all patients had no resting pain.Conclusions:OFA, is used to avoid short-term and long-term adverse effects of opioids, such as: nausea, postoperative hyperalgesia, chronic pain and tumor recurrence. The ESPB allows to practice anesthesia and analgesia in a safe way.

5 - THE ANALGESIC EFFICACY OF PECS 2 BLOCK FOLLOWING RADICAL MASTECTOMY: A RANDOMISED, CONTROLLED, TRIPLE-BLINDED TRIAL.

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 5 - THE ANALGESIC EFFICACY OF PECS 2 BLOCK FOLLOWING RADICAL MASTECTOMY: A RANDOMISED, CONTROLLED, TRIPLE-BLINDED TRIAL. by :

Download or read book 5 - THE ANALGESIC EFFICACY OF PECS 2 BLOCK FOLLOWING RADICAL MASTECTOMY: A RANDOMISED, CONTROLLED, TRIPLE-BLINDED TRIAL. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background. The pectoral nerves 2 (PECS2) block is a regional anaesthetic technique developed to relieve pain after breast surgery, but efficacy data following radical mastectomy are scarce. This randomised controlled triple-blinded trial tested the hypothesis that PECS2 block would provide effective analgesia after radical mastectomy.Methods. Fifty patients scheduled for radical mastectomy under general anesthesia were randomly allocated either to receive a PECS2 block or receive no block, after induction of general anesthesia. Perioperative multimodal analgesic treatment consisted of dexamethasone, magnesium, paracetamol, ibuprofen and intravenous morphine patient-controlled analgesia, following a pre-defined protocol. The primary outcome was intravenous morphine consumption at 24 h postoperatively. Secondary outcomes were cumulative intravenous morphine consumption at 2 and 48 postoperative hours, visual analogue pain scores at rest at 2, 24 and 48 postoperative hours, presence of postoperative nausea and vomiting and pruritus at 24 and 48 postoperative hours, and presence of chronic pain at 6 postoperative months.Results. Demographic data were equivalent in both groups. Intravenous morphine consumption at 24 postoperative hours was significantly reduced in the PECS2 group (5.0 mg, 95%CI:2.5-7.5) compared to the control group (9.7 mg, 95%CI:5.8-13.7, p=0.04). The secondary pain outcomes were also similar between groups (table 2), with the exception for intravenous morphine consumption at 48 postoperative hours in favor of the PECS2 group (6.0 mg, 95%CI:2.7-9.2) compared to the control group (12.5 mg, 95%CI:6.7-18.8, p=0.04).Conclusions. The PECS2 block provides marginal postoperative analgesia in the setting of peri-operative multi-modal analgesic treatment after radical mastectomy, without impact on chronic postoperative pain.

Perioperative Pain Management

Author : Richard D. Urman
Publisher : Oxford University Press
ISBN 13 : 0199937214
Total Pages : 141 pages
Book Rating : 4.1/5 (999 download)

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Book Synopsis Perioperative Pain Management by : Richard D. Urman

Download or read book Perioperative Pain Management written by Richard D. Urman and published by Oxford University Press. This book was released on 2013-05-23 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Perioperative Pain Management is an up-to-date, evidence-based guide for clinicians who diagnose and treat post-surgical patients.

6 - COMPARISON OF ERECTOR SPINAE PLANE BLOCK AND PARAVERTEBRAL BLOCK FOR BREAST SURGERY: A RETROSPECTIVE ANALYSIS

Author : Aumjit Wittayapairoj
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 6 - COMPARISON OF ERECTOR SPINAE PLANE BLOCK AND PARAVERTEBRAL BLOCK FOR BREAST SURGERY: A RETROSPECTIVE ANALYSIS by : Aumjit Wittayapairoj

Download or read book 6 - COMPARISON OF ERECTOR SPINAE PLANE BLOCK AND PARAVERTEBRAL BLOCK FOR BREAST SURGERY: A RETROSPECTIVE ANALYSIS written by Aumjit Wittayapairoj and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Aims:Thoracic paravertebral block (PVB) is an established technique for perioperative pain management for breast surgery. However, since this block is technically challenging, it has not been widely used. Recently introduced erector spinae plane block (ESPB) requires less technical expertise and may be an alternative to PVB. However, the two blocks have not been fully compared. The present study retrospectively analyzed data saved in our registry to compare the two blocks in patients undergoing breast surgery. Methods: After IRB approval, we extracted data for breast surgery patients receiving either PVB or ESPB under ultrasound guidance from June 2018 to March 2019. We compared intra and postoperative data. The primary outcome was visual analogue pain scores (VAS) at rest at 12 h after block. The secondary outcome included scanning and performing time for block, dermatomal sensory blockade, and postoperative fentanyl consumption for 24 h. Results: Twenty-six PVB and 25 ESPB patients were evaluated. Patient demographics were comparable. VAS at rest at 12 h was similar [PVB 13 (0-30) vs ESPB 25 (12-40), P=0.069] [median (IQR)]. However, VAS at rest at 6 h was lower after PVB [10 (0-24)] than after ESPB [25 (18-40)] (P

CONTINUOUS ERECTOR SPINAE PLANE BLOCK IS A VALID POSTOPERATIVE ANALGESIC ALTERNATIVE IN VARIOUS SURGICAL PROCEDURES.

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis CONTINUOUS ERECTOR SPINAE PLANE BLOCK IS A VALID POSTOPERATIVE ANALGESIC ALTERNATIVE IN VARIOUS SURGICAL PROCEDURES. by :

Download or read book CONTINUOUS ERECTOR SPINAE PLANE BLOCK IS A VALID POSTOPERATIVE ANALGESIC ALTERNATIVE IN VARIOUS SURGICAL PROCEDURES. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The erector spinae plane block, first described by Forero et al in 2016 for thoracic neuropathic pain, has gained popularity as an alternative technique to neuraxial post-operative analgesia. We performed a retrospective analysis of the records of the patients that received a continuous erector spinae plane block for postoperative analgesia, in our hospital, from September 2017 to April 2018. The statistical analysis was done with SPSS (version 23).We analyzed 37 patients. Procedures ranged from plastic, thoracic, orthopedic, gynecologic and general surgery (table 1). Blocks were performed at a mid-thoracic, low-thoracic or low-lumbar level, according to the type of surgery. Patients received a loading bolus between 20 and 30ml of ropivacaine 0.5% followed by intermittent boluses of 10ml of ropivacaine 0.2% every 2 hours. The median duration of catheter use was 2 days. Pain scores (NRS) during the first three post-operative days varied from 0 to 1.4 at rest and 2.3 to 4.0 with movement (table 2). No other rescue medication was needed. No adverse effects were recorded.This analysis shows that post-operative analgesia with continuous erector spinae plane block can be a valid choice for various surgical procedures. Cumulative evidence of good analgesic efficacy, safety profile and ease of handling could prove this block to be an attractive alternative when neuraxial blockade is not deemed suitable or easily manageable.

2 - ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VATS: A SAFE AND EFFECTIVE ALTERNATIVE TO EPIDURAL ANALGESIA.

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis 2 - ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VATS: A SAFE AND EFFECTIVE ALTERNATIVE TO EPIDURAL ANALGESIA. by :

Download or read book 2 - ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA AFTER VATS: A SAFE AND EFFECTIVE ALTERNATIVE TO EPIDURAL ANALGESIA. written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction: Postoperative pain increases the morbidity and mortality after surgery. It gains importance in thoracic surgery, because the rehabilitation is essential in the initial postoperative period. For this reason, alternative analgesic techniques to the epidural are useful for cases in which epidural wasnu2019t possible.Case report: Fifty years old woman scheduled for right inferior lobectomy by VATS. In this case, epidural catheter couldnu2019t be possible due to a osteoporotic fracture at spinous process of the fifth and sixth thoracic vertebras. We performed an ESP blocks at the T5 level. About 3 centimeters lateral to the transverse process of T5 localizated the rhomboid, trapezius and erector spinal muscles. The inferior fascia of the erector muscle of the spine was located with a Tuhoy needle. We administrated 25cc of levobupivacaine 0.5% to dissect the interfascial space and placed a catheter at this level. We used analgesia by the catheter in the intraoperatory and first three postoperative days. Postoperative pain was less than 4 over 10 in VAS, during the postoperative period.Conclusions: The erector spinae plane block is a simple technique of postoperative analgesia, easily reproducible with an adequate safety profile that allows a good analgesic control in postoperative pain after videothoracoscopy.