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Anesthetic Techniques In Breast Surgery

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https://www.readbyqxmd.com/read/30063656/serratus-plane-block-a-cadaveric-study-to-evaluate-optimal-injectate-spread
#1
Abhijit Biswas, Valera Castanov, Zhi Li, Anahi Perlas, Richelle Kruisselbrink, Anne Agur, Vincent Chan
BACKGROUND AND OBJECTIVES: Although serratus plane block reportedly provides satisfactory analgesia for breast and thoracic surgeries, the optimal technique for consistent success has not been studied. The goal of this anatomical study was to evaluate the impact of volume, level, and site of injection on the extent of injectate spread that can influence anesthetic coverage. METHODS: Ultrasound-guided dye injection and subsequent dissection were performed in 39 cadaveric hemithoraces...
July 30, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/30037430/pectoral-nerve-block-as-a-single-anesthetic-technique-for-breast-surgery-and-sentinel-lymph-node-investigation
#2
M Campos, J Azevedo, L Mendes, H Rebelo
Breast cancer surgery is usually performed under general anesthesia or, more recently, combined with conventional regional techniques. Pectoral nerves (PECs) block appears as an analgesic alternative in these procedures, but few studies refer to it as a single anesthetic technique1-3 . In this case report, we describe a 56-year-old female patient, BMI 31kg/m2 , ASA IV, admitted for elective tumorectomy of the left upper quadrant of the breast and sentinel node investigation. Given the multiple comorbidities and the high anesthetic and surgical risk, the anaesthetic plan consisted in ultrasound guided PECs II block as a single anesthetic technique...
July 20, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29738329/transthoracic-arteriovenous-graft-repair-with-the-pectoralis-pecs-ii-nerve-block-for-primary-intraoperative-anesthesia-and-postoperative-analgesia-a-case-report
#3
Gabriel Farkas, Garret Weber, Jonathon Miller, Jeff Xu
The PECS II nerve block is a relatively new regional anesthetic technique that targets the medial and lateral pectoral nerves, as well as the lateral cutaneous branches of the intercostal nerves. It has been described for surgical cases involving the breast, as an adjunct or alternative to neuraxial or paravertebral techniques. This case report describes the first successful use of the PECS II nerve block placed using ultrasound guidance as the primary anesthetic and postoperative analgesic in a non-breast-related chest wall surgery...
May 7, 2018: A&A practice
https://www.readbyqxmd.com/read/29714650/real-time-view-of-anesthetic-solution-spread-during-an-ultrasound-guided-thoracic-paravertebral-block
#4
Domenico P Santonastaso, Annabella de Chiara, Marco Rispoli, Giovanni Musetti, Vanni Agnoletti
BACKGROUND: Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performed with or without ultrasound guidance. The ultrasound guidance technique can be used to identify the thoracic paravertebral space, guide needle placement, monitor the spread of local anesthetic (LA) solution, and reduce complications such as pleural puncture and pneumothorax. The possibility of assessing anesthetic spread in real time using ultrasound guidance during paravertebral block offers numerous advantages, including the immediate and accurate identification of the extent of nervous block, with a consequent reduction of LA dose...
March 1, 2018: Tumori
https://www.readbyqxmd.com/read/29672368/pectoral-i-block-does-not-improve-postoperative-analgesia-after-breast-cancer-surgery-a-randomized-double-blind-dual-centered-controlled-trial
#5
Jérôme Cros, Patrick Sengès, Suzan Kaprelian, Julie Desroches, Caroline Gagnon, Anaïs Labrunie, Benoît Marin, Sabrina Crépin, Nathalie Nathan, Pierre Beaulieu
BACKGROUND AND OBJECTIVES: General anesthesia for breast surgery may be supplemented by using a regional anesthetic technique. We evaluated the efficacy of the first pectoral nerve block (Pecs I) in treating postoperative pain after breast cancer surgery. METHODS: A randomized, double-blind, dual-centered, placebo-controlled trial was performed. One hundred twenty-eight patients scheduled for unilateral breast cancer surgery were recruited. A multimodal analgesic regimen and surgeon-administered local anesthetic infiltration were used for all patients...
August 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29537724/outcomes-of-outpatient-breast-cancer-surgery-at-a-private-breast-clinic
#6
Ryungsa Kim, Ami Kawai, Megumi Wakisaka, Yuri Funaoka, Yui Nishida, Naomi Yasuda, Koji Arihiro
Advances in surgical and anesthetic techniques have allowed for outpatient treatment of breast cancer. We evaluated the feasibility, safety, efficacy, and surgical outcomes of outpatient surgery in 370 patients with breast cancer who underwent breast-conserving surgery (BCS)/axillar lymph node (ALN) management. There were no deaths or severe intraoperative complications, but 41 complications were observed and disease recurrence occurred in 18 patients. The cumulative overall survival rate was 95.2%. Outpatient surgery was well tolerated, feasible, and safe in patients receiving BCS/ALN management...
July 2018: Breast Journal
https://www.readbyqxmd.com/read/29462058/comparison-of-paravertebral-block-by-anatomic-landmark-technique-to-ultrasound-guided-paravertebral-block-for-breast-surgery-anesthesia-a-randomized-controlled-trial
#7
Rupali Patnaik, Anjolie Chhabra, Rajeshwari Subramaniam, Mahesh K Arora, Devalina Goswami, Anurag Srivastava, Vuthaluru Seenu, Anita Dhar
BACKGROUND AND OBJECTIVES: Paravertebral block (PVB) is an established technique for providing anesthesia for breast surgery. The primary objective was to compare anatomical landmark technique (ALT) to the ultrasound-guided (USG) PVB block for providing surgical anesthesia. Secondary objectives included comparison of perioperative analgesia and complications. METHODS: This randomized, controlled, observer-blinded study included 72 females, aged 18 to 65 years, American Society of Anesthesiologists physical status I or II, undergoing elective unilateral breast surgery...
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29416236/dexmedetomidine-as-an-adjunctive-analgesic-to-ropivacaine-in-pectoral-nerve-block-in-oncological-breast-surgery-a-randomized-double-blind-prospective-study
#8
Haramritpal Kaur, Poonam Arora, Gurpreet Singh, Amandeep Singh, Shobha Aggarwal, Mukesh Kumar
Background and Aims: Pectoral nerve block (Pecs) using local anesthetic (LA) agent is a newer analgesic technique for breast surgeries. This study further evaluates the effect of addition of dexmedetomidine to LA agent on total duration of analgesia and postoperative morphine consumption. Material and Methods: A total of 60 American Society of Anesthesiologist Grade I and II female patients with age ≥18 years, scheduled for oncological breast surgery, were enrolled in the study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29284840/effect-of-clonidine-as-adjuvant-in-thoracic-paravertebral-block-for-patients-undergoing-breast-cancer-surgery-a-prospective-randomized-placebo-controlled-double-blind-study
#9
Nairita Mayur, Anjan Das, Hirak Biswas, Subinay Chhaule, Surajit Chattopadhyay, Tapobrata Mitra, Sandip Roybasunia, Subrata Kumar Mandal
Background and Aims: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29260419/comparative-effectiveness-of-preoperative-paravertebral-block-for-post-mastectomy-reconstruction-a-systematic-review-of-the-literature
#10
Anaeze C Offodile, Mario A Aycart, Jodi B Segal
INTRODUCTION: Paravertebral block (PVB) has emerged as a viable strategy for improving postoperative outcomes in breast surgery; however, it is unclear whether these benefits extend to recipients of post-mastectomy reconstruction (PMR). METHODS: A systematic search of the PubMed, EMBASE, Web of Science and Cochrane Library electronic databases was conducted for all studies matching the a priori inclusion criteria (inception to 1 March 2017). Independent assessment by two reviewers, in stages, of the title/abstract and full text was performed...
March 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29102405/erector-spinae-plane-block-for-radical-mastectomy-a-new-indication
#11
M Veiga, D Costa, I Brazão
The erector spinae plane block is a technique recently described by Forero et al. in September 2016. It has applications in the control of chronic pain with neuropathic component of the chest wall, and for pain control in thoracoscopic surgery. In this article, we describe the use of this technique as part of a multimodal analgesic approach in a 40-year-old woman, who underwent radical mastectomy due to breast cancer. By performing this block before anesthetic induction, we have achieved an opioid sparing effect, avoiding a possible immunomodulatory effect, although not yet proven in humans...
February 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28905322/differences-in-immune-response-to-anesthetics-used-for-day-surgery-versus-hospitalization-surgery-for-breast-cancer-patients
#12
Ryungsa Kim, Ami Kawai, Megumi Wakisaka, Yuri Funaoka, Shoichiro Ohtani, Mitsuya Ito, Takayuki Kadoya, Morihito Okada
BACKGROUND: Surgery/anesthetic technique-stimulated immunosuppression may be associated with outcome for cancer patients. Here, the immune responses of patients undergoing day surgery versus hospitalization surgery for breast cancer were compared in a prospective study. METHODS: Between February 2012 and August 2014, 21 breast cancer patients underwent day surgery and 16 breast cancer patients underwent hospitalization surgery. The former group received lidocaine/propofol/pethidine, while propofol/systemic opioid- and sevoflurane/propofol/systemic opioid-based anesthesia were administered to the latter group...
September 14, 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/28867151/-axillary-local-anesthetic-spread-after-the-thoracic-interfacial-ultrasound-block-a-cadaveric-and-radiological-evaluation
#13
Patricia Alfaro de la Torre, Jerry Wayne Jones, Servando López Álvarez, Paula Diéguez Garcia, Francisco Javier Garcia de Miguel, Eva Maria Monzon Rubio, Federico Carol Boeris, Monir Kabiri Sacramento, Osmany Duany, Mario Fajardo Pérez, Borja de la Quintana Gordon
BACKGROUND: Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. METHODS: After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane...
November 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28664348/paravertebral-blocks-for-same-day-breast-surgery
#14
REVIEW
Mark R Jones, Graham R Hadley, Alan D Kaye, Philipp Lirk, Richard D Urman
PURPOSE OF REVIEW: Breast surgery, performed for medical or cosmetic reasons, remains one of the most frequently performed procedures, with over 500,000 cases performed annually in the USA alone. Historically, general anesthesia (GA) has been widely accepted as the gold-standard technique, while epidural anesthesia was largely considered too invasive and thus unnecessary for breast surgery. Over the past years, paravertebral block (PVB) has emerged as an alternative analgesic or even anesthetic technique...
August 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28558008/expression-of-anaesthetic-and-analgesic-drug-target-genes-in-excised-breast-tumour-tissue-association-with-clinical-disease-recurrence-or-metastasis
#15
C Connolly, S F Madden, D J Buggy, H C Gallagher
BACKGROUND: Retrospective analyses suggest anaesthetic-analgesics technique during cancer surgery may affect recurrence/metastasis. This could involve direct effects of anaesthetic-analgesic drugs on cancer cells. While μ-opioid receptor over-expression in lung tumours is associated with greater metastasis, other anaesthetic-analgesic receptor targets in cancer recurrence/metastasis remain unexplored. Therefore, we evaluated the association between genetic expression of anaesthetic-analgesic receptor targets and recurrence/metastasis, using a repository of breast cancer gene expression and matching clinical data...
2017: PloS One
https://www.readbyqxmd.com/read/28280667/intradermal-infiltration-of-local-anesthetic-rapid-and-bloodless-deepithelialization-of-the-breast-pedicle
#16
Katelyn G Bennett, Robert H Gilman
Breast reduction is one of the most commonly performed plastic surgery procedures, and pedicle deepithelialization remains a time-consuming step of the operation. This is especially true when using an inferior pedicle. We present a novel technique of intradermal infiltration of the breast pedicle with local anesthetic to facilitate efficient, bloodless deepithelialization. The senior author uses a 20-ml syringe to inject 0.25% lidocaine and 1:400,000 epinephrine just beneath the epidermis of the breast pedicle to create a series of wheals...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28272228/comparison-of-surgical-conditions-in-2-different-anesthesia-techniques-of-esmolol-induced-controlled-hypotension-in-breast-reduction-surgery
#17
RANDOMIZED CONTROLLED TRIAL
Ahmet Besir, Bahanur Cekic, Dilek Kutanis, Ali Akdogan, Murat Livaoglu
BACKGROUND: Breast reduction surgery is a common cosmetic surgery with a high incidence of blood loss and transfusion. In this surgery, the reduction of blood loss related to surgical manipulation and the volume of resected tissue is a target. In the present study, we compared the effects of esmolol-induced controlled hypotension on surgical visibility, surgical bleeding, and the duration of surgery in patients anesthetized with propofol/remifentanil (PR) or sevoflurane/remifentanil (SR)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27899130/antibiotic-prophylaxis-in-reduction-mammaplasty-study-protocol-for-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Edgard Silva Garcia, Daniela Francescato Veiga, Joel Veiga-Filho, Isaías Vieira Cabral, Natália Lana Larcher Pinto, Neil Ferreira Novo, Miguel Sabino Neto, Lydia Masako Ferreira
BACKGROUND: The role of antibiotics in surgical procedures where the risk of surgical site infection (SSI) is low remains uncertain. There is, to date, no evidence to justify the routine use of antibiotics in postoperative reduction mammaplasty. The aim of this study is to evaluate the effect of postoperative antibiotic treatment on the occurrence of SSI after breast reduction surgery. METHODS: This is a double-blind randomized clinical trial with 124 breast hypertrophy patients allocated to two treatment groups: antibiotic (n = 62) and placebo (n = 62)...
November 30, 2016: Trials
https://www.readbyqxmd.com/read/27871558/combipecs-the-single-injection-technique-of-pectoral-nerve-blocks-1-and-2-a-case-series
#19
Arunangshu Chakraborty, Rakhi Khemka, Taniya Datta, Suparna Mitra
Ultrasound-guided Pecs block can provide perioperative analgesia for breast surgery. A single-injection technique (COMBIPECS) combines both Pecs 1 and Pecs 2 blocks in a single needle pass. This technique saves time and is equally effective as the modified Pecs block which uses 2 needle passes. We present a case series of 21 patients who received the COMBIPECS block as a part of multimodal analgesia for breast cancer surgery. The block was administered before the surgery after induction of general anesthesia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687427/the-effect-of-serratus-plane-block-performed-under-direct-vision-on-postoperative-pain-in-breast-surgery
#20
COMPARATIVE STUDY
Marcus Hards, Arisa Harada, Isobel Neville, Sheelagh Harwell, Mahwash Babar, Abdulsatar Ravalia, Giles Davies
STUDY OBJECTIVES: To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. DESIGN: We performed a retrospective study of elective breast surgery patients undergoing mastectomy over 6 months. We collected data on the outcomes for the pain score and use of analgesia in recovery, the use of analgesia and antiemetics overnight, and the pain score and mobilization status of the patient 1 day after the operation...
November 2016: Journal of Clinical Anesthesia
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