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Nerve block mastectomy

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https://www.readbyqxmd.com/read/27847703/treatment-of-post-latissimus-dorsi-flap-breast-reconstruction-pain-with-continuous-paravertebral-nerve-blocks-a-retrospective-review
#1
Jonathan T Unkart, Jennifer A Padwal, Brian M Ilfeld, Anne M Wallace
OBJECTIVES: The addition of a perioperative continuous paravertebral nerve block (cPVB) to a single-injection thoracic paravertebral nerve block (tPVB) has demonstrated improved analgesia in breast surgery. However, its use following isolated post-mastectomy reconstruction using a latissimus dorsi flap (LDF) has not previously been examined. METHODS: We performed a retrospective review of patients who underwent salvage breast reconstruction with a unilateral LDF by a single surgeon...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27687427/the-effect-of-serratus-plane-block-performed-under-direct-vision-on-postoperative-pain-in-breast-surgery
#2
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
https://www.readbyqxmd.com/read/27676665/efficacy-and-safety-of-ketamine-added-to-local-anesthetic-in-modified-pectoral-block-for-management-of-postoperative-pain-in-patients-undergoing-modified-radical-mastectomy
#3
Ahmed H Othman, Ahmad M Abd El-Rahman, Fatma El Sherif
BACKGROUND: Breast surgery is an exceedingly common procedure with an increased incidence of acute and chronic pain. Pectoral nerve block is a novel peripheral nerve block alternative to neuro-axial and paravertebral blocks for ambulatory breast surgeries. OBJECTIVES: This study aims to compare the analgesic efficacy and safety of modified Pecs block with ketamine plus bupivacaine versus bupivacaine in patients undergoing breast cancer surgery. STUDY DESIGN: A randomized, double-blind, prospective study...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27543533/efficacy-of-pectoral-nerve-block-versus-thoracic-paravertebral-block-for-postoperative-analgesia-after-radical-mastectomy-a-randomized-controlled-trial
#4
S Kulhari, N Bharti, I Bala, S Arora, G Singh
BACKGROUND: Pectoral nerve (PecS) block is a recently introduced technique for providing surgical anaesthesia and postoperative analgesia during breast surgery. The present study was planned to compare the efficacy and safety of ultrasound-guided PecS II block with thoracic paravertebral block (TPVB) for postoperative analgesia after modified radical mastectomy. METHODS: Forty adult female patients undergoing radical mastectomy were randomly allocated into two groups...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26513674/harlequin-syndrome-after-thoracic-paravertebral-block
#5
Yasuko Nagasaka, Gunnar Wasner, Balram Sharma, Katharine Fleischmann
Harlequin syndrome is characterized by the sudden onset of unilateral facial flushing and sweating, often preceded by exercise, excessive heat, or, rarely, regional anesthesia. Although the exact mechanism remains unclear, it is often referred to as transient or permanent interruption of the sympathetic nervous system. We present a case of Harlequin syndrome without Horner syndrome in a patient with unilateral right-sided facial flushing that started shortly after a left-sided thoracic paravertebral nerve block for a mastectomy...
February 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/26437549/-serratus-intercostal-plane-block-for-brest-surgery
#6
Yuichi Ohgoshi, Motoi Yokozuka, Katsuyuki Terajima
BACKGROUND: Serratus-intercostal plane block (SIPB) is a novel ultrasound-guided thoracic wall nerve block reported recently. We performed SIPB for perioperative analgesia together with general anesthesia in patients undergoing partial mastectomy. METHODS: We chose the patients with breast cancer of upper to lower lateral quadrant or subareolar region. The patients received general anesthesia followed by ultrasound-guided SIPB. The needle was introduced in the midaxillary line at the level of the fourth or fifth rib...
June 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26086619/paravertebral-block-for-inguinal-herniorrhaphy-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
REVIEW
Lawrence Siu-Chun Law, Mingjuan Tan, Yaowu Bai, Timothy E Miller, Yi-Ju Li, Tong-Joo Gan
BACKGROUND: Paravertebral block (PVB) is a safe and effective anesthetic technique for thoracotomy and mastectomy. However, no systematic review or meta-analysis has focused on PVB for inguinal herniorrhaphy. Our study compares PVB with general anesthesia/systemic analgesia, neuraxial blocks, and other peripheral nerve blocks. METHODS: We analyzed 14 randomized controlled trials from PubMed, MEDLINE, CENTRAL, EMBASE, and CINAHL up to February 2015, without language restriction, comparing PVB under sedation with general anesthesia/systematic analgesia (135 vs 133 patients), neuraxial blocks (191 vs 186 patients), and other peripheral nerve blocks (119 vs 117 patients)...
August 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25957529/single-injection-thoracic-paravertebral-block-and-postoperative-analgesia-after-mastectomy-a-retrospective-cohort-study
#8
Rishi R Agarwal, Anne M Wallace, Sarah J Madison, Anya C Morgan, Edward J Mascha, Brian M Ilfeld
BACKGROUND: The treatment of postoperative pain after mastectomy is an area of increasing interest, as this treatment option is now considered a standard of care for those affected by breast cancer. Thoracic paravertebral nerve block (tPVB) using local anesthetics administered before mastectomy can theoretically provide postoperative analgesia, thereby facilitating a more comfortable and shorter hospitalization. METHODS: In this retrospective cohort study, we aimed to determine the duration and degree to which tPVB provides postoperative analgesia in patients who underwent either unilateral or bilateral mastectomy (n = 182)...
August 2015: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/25886701/effect-of-paravertebral-nerve-blocks-on-narcotic-use-after-mastectomy-with-reconstruction
#9
Carl Glissmeyer, William Johnson, Bernard Sherman, Margaret Glissmeyer, Jennifer Garreau, Nathalie Johnson
INTRODUCTION: Pain control outcomes using local anesthetic delivery systems vs usual narcotics at our institution revealed that use of local anesthetic delivery systems decreased narcotic use greater than 40% in patients with no reconstruction but had very little effect in patients receiving reconstruction. As part of our quality improvement program, the anesthesiology department trained and began offering paravertebral blocks (PVBs) to patients having reconstruction. We reviewed pain control outcomes to understand how the use of paravertebral nerve blocks affected narcotic use in reconstructed patients...
May 2015: American Journal of Surgery
https://www.readbyqxmd.com/read/25413267/persistent-postmastectomy-pain-and-pain-related-physical-and-emotional-functioning-with-and-without-a-continuous-paravertebral-nerve-block-a-prospective-1-year-follow-up-assessment-of-a-randomized-triple-masked-placebo-controlled-study
#10
Brian M Ilfeld, Sarah J Madison, Preetham J Suresh, NavParkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, Edward J Mascha, Zekun Xu, Cindy H Wen, Anya C Morgan, Anne M Wallace
BACKGROUND: In a previous randomized, triple-masked, placebo-controlled study, the authors demonstrated that extending a single-injection paravertebral nerve block with a multiple-day perineural local anesthetic infusion improves analgesia and decreases pain-related dysfunction during the 3-day infusion but not subsequent to catheter removal within 1 month after mastectomy. This report describes a prospective follow-up study of the previously published trial to investigate the possibility that extending a single-injection paravertebral block with a multiple-day infusion may decrease persistent postsurgical pain as well as pain-induced emotional and functional dysfunction 1 year after mastectomy...
2015: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/25376971/pectoral-nerves-i-and-ii-blocks-in-multimodal-analgesia-for-breast-cancer-surgery-a-randomized-clinical-trial
#11
RANDOMIZED CONTROLLED TRIAL
Ghada Mohammad Nabih Bashandy, Dina Nabil Abbas
BACKGROUND: The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Our study aimed to compare prospectively the quality of analgesia after modified radical mastectomy surgery using general anesthesia and Pecs blocks versus general anesthesia alone. METHODS: One hundred twenty adult female patients scheduled for elective unilateral modified radical mastectomy under general anesthesia were randomly allocated to receive either general anesthesia plus Pecs block (Pecs group, n = 60) or general anesthesia alone (control group, n = 60)...
January 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/25059839/thermal-imaging-evaluation-of-paravertebral-block-for-mastectomy-in-high-risk-patient-case-report
#12
Marcin Możański, Bartosz Rustecki, Bolesław Kalicki, Anna Jung
Thoracic paravertebral block is the technique of injecting local anesthetic adjacent to the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina. It is effective in treating acute and chronic pain of unilateral origin from the chest and abdomen. This technique causes pain relief with pulmonary function preservation and great hemodynamic stability. 66 year old woman (156 cm, 80 kg, BMI 32) with chronic right heart failure, hypertension and obesity, on chronic oxygen therapy was presented for elective mastectomy due to breast cancer...
April 2015: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/24754569/retrospective-clinical-evaluation-of-ultrasound-guided-transverse-abdominis-plane-block-in-dogs-undergoing-mastectomy
#13
Diego A Portela, Marta Romano, Angela Briganti
HISTORY: Eleven female dogs of different breeds undergoing unilateral radical (n = 7) or regional abdominal mastectomy (n = 4) received an ultrasound guided transverse abdominis plane block (TAP-block). PHYSICAL EXAMINATION: Subjects showed single or multiple mammary tumours. Serum biochemistry, CBC and electrocardiogram were unremarkable. Eight animals were classified as ASA physical status II and 3 as ASA III. MANAGEMENT: Dogs were premedicated with methadone [0...
May 2014: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/24448512/treatment-of-postmastectomy-pain-with-ambulatory-continuous-paravertebral-nerve-blocks-a-randomized-triple-masked-placebo-controlled-study
#14
RANDOMIZED CONTROLLED TRIAL
Brian M Ilfeld, Sarah J Madison, Preetham J Suresh, Navparkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace, James A Proudfoot, Anya C Morgan, Cindy H Wen, Anne M Wallace
BACKGROUND: We aimed to determine with this randomized, triple-masked, placebo-controlled study if benefits are afforded by adding a multiple-day, ambulatory, continuous ropivacaine paravertebral nerve block to a single-injection ropivacaine paravertebral block after mastectomy. METHODS: Preoperatively, 60 subjects undergoing unilateral (n = 24) or bilateral (n = 36) mastectomy received either unilateral or bilateral paravertebral perineural catheter(s), respectively, inserted between the third and fourth thoracic transverse process(es)...
March 2014: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/24325953/transversus-abdominis-plane-block-following-abdominally-based-breast-reconstruction-study-protocol-for-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Toni Zhong, Marie Ojha, Shaghayegh Bagher, Kate Butler, Anne C O'Neill, Stuart A McCluskey, Hance Clarke, Stefan O P Hofer, Coimbatore Srinivas
BACKGROUND: Breast reconstruction using the free muscle-sparing transversus abdominus myocutaneous or deep inferior epigastric perforator flaps are common methods for restoring mastectomy defects for breast cancer patients. Despite its increasing popularity and safety, the abdominal donor site remains a major source of postoperative pain. Conventional postoperative pain relief protocol consists primarily of a patient-controlled anesthesia device delivering intravenous opioids. Opioids can cause numerous side effects such as sedation, headache, nausea, vomiting, breathing difficulties and bladder and bowel dysfunction...
2013: Trials
https://www.readbyqxmd.com/read/23632052/guided-paravertebral-blocks-with-versus-without-clonidine-for-women-undergoing-breast-surgery-a-prospective-double-blinded-randomized-study
#16
RANDOMIZED CONTROLLED TRIAL
Zoher M Naja, Fouad M Ziade, Mariam A El-Rajab, Nicole Naccash, Jean-Marc Ayoubi
BACKGROUND: Paravertebral blocks (PVBs) have been introduced as an alternative to general anesthesia for breast cancer surgeries. The addition of clonidine as an adjuvant in PVBs may enhance quality and duration of analgesia and significantly reduce the consumption of analgesics after breast surgery. In this prospective randomized double-blind study, we assessed the significance of adding clonidine to the anesthetic mixture for women undergoing mastectomy. METHODS: Sixty patients were randomized equally into 2 groups, both of which received PVB block, either with or without clonidine...
July 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/23142025/transversus-abdominis-plane-tap-catheters-inserted-under-direct-vision-in-the-donor-site-following-free-diep-and-ms-tram-breast-reconstruction-a-prospective-cohort-study-of-45-patients
#17
COMPARATIVE STUDY
Toni Zhong, Karen W Wong, Homan Cheng, Marie Ojha, Coimbatore Srinivas, Stuart A McCluskey, Hance Clarke, Lindsay Jacks, Stefan O P Hofer
INTRODUCTION: The transversus abdominis plane (TAP) block is a peripheral nerve block of T6-L1 intercostal nerves of the abdominal wall. The purpose of this study was to evaluate the usefulness of intermittent TAP blockade for the first two postoperative days following free muscle sparing-transverse rectus abdominis muscle (MS-TRAM) or deep inferior epigastric perforator (DIEP) flap reconstruction of the breast. Therapeutic--Level II evidence. MATERIAL AND METHODS: This prospective cohort consisted of 45 consecutive patients who underwent DIEP or MS-TRAM free-flap breast reconstruction...
March 2013: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/23064793/use-of-preoperative-paravertebral-block-decreases-length-of-stay-in-patients-undergoing-mastectomy-plus-immediate-reconstruction
#18
Suzanne B Coopey, Michelle C Specht, Lisa Warren, Barbara L Smith, Jonathan M Winograd, Katharine Fleischmann
BACKGROUND: A prior study in patients undergoing breast surgery with and without the use of paravertebral blocks (PVB) found no significant difference in patient length of stay (LOS). However, patients undergoing bilateral procedures and those undergoing immediate reconstructions were excluded. We sought to determine if the use of PVB in patients undergoing unilateral or bilateral mastectomy plus immediate reconstruction decreases patient LOS. METHODS: We undertook a retrospective review of patients who had mastectomies with immediate reconstructions with and without the use of preoperative PVB...
April 2013: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/22447075/genetically-determined-p2x7-receptor-pore-formation-regulates-variability-in-chronic-pain-sensitivity
#19
MULTICENTER STUDY
Robert E Sorge, Tuan Trang, Ruslan Dorfman, Shad B Smith, Simon Beggs, Jennifer Ritchie, Jean-Sebastien Austin, Dmitri V Zaykin, Heather Vander Meulen, Michael Costigan, Teri A Herbert, Merav Yarkoni-Abitbul, David Tichauer, Jessica Livneh, Edith Gershon, Ming Zheng, Keith Tan, Sally L John, Gary D Slade, Joanne Jordan, Clifford J Woolf, Gary Peltz, William Maixner, Luda Diatchenko, Ze'ev Seltzer, Michael W Salter, Jeffrey S Mogil
Chronic pain is highly variable between individuals, as is the response to analgesics. Although much of the variability in chronic pain and analgesic response is heritable, an understanding of the genetic determinants underlying this variability is rudimentary. Here we show that variation within the coding sequence of the gene encoding the P2X7 receptor (P2X7R) affects chronic pain sensitivity in both mice and humans. P2X7Rs, which are members of the family of ionotropic ATP-gated receptors, have two distinct modes of function: they can function through their intrinsic cationic channel or by forming nonselective pores that are permeable to molecules with a mass of up to 900 Da...
March 25, 2012: Nature Medicine
https://www.readbyqxmd.com/read/22273232/regional-block-anesthesia-for-mastectomy-a-community-hospital-experience
#20
COMPARATIVE STUDY
Charles L Neustein, Anita Turner
This report describes a community hospital experience with regional anesthesia for mastectomy. The authors believe this is a modality deserving of wider application. This report is intended to illuminate the benefits of the approach.
December 2011: American Surgeon
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