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https://www.readbyqxmd.com/read/29777144/benefits-in-radical-mastectomy-protocol-a-randomized-trial-evaluating-the-use-of-regional-anesthesia
#1
Marcio Matsumoto, Eva M Flores, Pedro P Kimachi, Flavia V Gouveia, Mayra A Kuroki, Alfredo C S D Barros, Marcelo M C Sampaio, Felipe E M Andrade, João Valverde, Eduardo F Abrantes, Claudia M Simões, Rosana L Pagano, Raquel C R Martinez
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29720750/newer-regional-analgesia-interventions-fascial-plane-blocks-for-breast-surgeries-review-of-literature
#2
REVIEW
Rakesh Garg, Swati Bhan, Saurabh Vig
Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29706651/wild-type-p53-upregulates-an-early-onset-breast-cancer-associated-gene-gas7-to-suppress-metastasis-via-gas7-cyfip1-mediated-signaling-pathway
#3
Jer-Wei Chang, Wen-Hung Kuo, Chiao-Mei Lin, Wen-Ling Chen, Shih-Hsuan Chan, Meng-Fan Chiu, I-Shou Chang, Shih-Sheng Jiang, Fang-Yu Tsai, Chung-Hsing Chen, Pei-Hsin Huang, King-Jen Chang, Kai-Ti Lin, Sheng-Chieh Lin, Ming-Yang Wang, Yih-Huei Uen, Chi-Wen Tu, Ming-Feng Hou, Shih-Feng Tsai, Chen-Yang Shen, Shiao-Lin Tung, Lu-Hai Wang
The early onset breast cancer patients (age ≤ 40) often display higher incidence of axillary lymph node metastasis, and poorer five-year survival than the late-onset patients. To identify the genes and molecules associated with poor prognosis of early onset breast cancer, we examined gene expression profiles from paired breast normal/tumor tissues, and coupled with Gene Ontology and public data base analysis. Our data showed that the expression of GAS7b gene was lower in the early onset breast cancer patients as compared to the elder patients...
April 30, 2018: Oncogene
https://www.readbyqxmd.com/read/29696115/the-effect-of-ketamine-and-dexamethasone-in-combination-with-lidocaine-on-the-onset-and-duration-of-axillary-block-in-hand-and-forearm-soft-tissue-surgery
#4
Behrooz Zaman, Siavash Hojjati Ashrafi, Seyedalireza Seyed Siamdoust, Valiollah Hassani, Siavash Mohamad Taheri, Samad Noorizad
Background: Using peripheral nerve block compared to general anesthesia has gained more popularity due to reduced postoperative pain, less need for post-surgery analgesic drugs, reduced incidence of nausea, shortness of PACU time, and increased patient satisfaction. Objectives: The aim of this study was to compare the effect of ketamine and dexamethasone as additives to lidocaine on duration and onset of axillary block action. Methods: In this clinical trial, all patients who referred to Hazrat-e-Fatemeh hospital for forearm and hand soft tissue surgery with informed consent were randomly divided into three groups in order to examine the onset and duration of axillary block: lidocaine + ketamine, lidocaine + dexamethasone in axillary block, and lidocaine alone (control)...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29688930/the-erector-spinae-plane-block-provides-complete-surgical-anesthesia-in-breast-surgery-a-case-report
#5
Pedro Paulo Kimachi, Elaine Gomes Martins, Philip Peng, Mauricio Forero
We described the first ultrasound-guided erector spinae plane block that provided complete surgical anesthesia for a right-sided mastectomy and axillary dissection in a patient with high cardiovascular risk. The block targeted at T5, and 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 and dexamethasone 8 mg was administered. Complete anesthesia was accomplished in 20 minutes, and the patient received propofol infusion for sedation. The patient reported no pain and remained hemodynamically stable throughout the 2...
April 23, 2018: A&A practice
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
#6
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...
April 18, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29669333/the-role-of-proteasome-inhibitor-mg132-in-2-4-dinitrofluorobenzene-induced-atopic-dermatitis-in-nc-nga-mice
#7
Kozo Ohkusu-Tsukada, Daiki Ito, Kimimasa Takahashi
BACKGROUND: Although immunosuppressants for therapy of atopic dermatitis (AD) are still being sought, proteasome inhibitors are also potential candidates for the treatment of AD. Proteasome inhibitors exert various effects by blocking proteasomal degradation and help regulate processes such as apoptosis induction via caspase-9, cell cycle progression via cyclins, NF-κB inactivation via IκB, and downregulation of antigen cross-presentation. The cells targeted by proteasome inhibitors are therefore activated cells undergoing proliferation or differentiation, and antigen-presenting cells carrying out protein degradation...
April 18, 2018: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/29666885/referred-cramping-phantom-hand-pain-elicited-in-the-face-and-eliminated-by-peripheral-nerve-block
#8
Caroline Dietrich, Sandra Nehrdich, Annette Zimmer, Alexander Ritter, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
Phantom limb pain is a restricting condition for a substantial number of amputees with quite different characteristics of pain. Here, we report on a forearm amputee with constant phantom pain in the hand, in whom we could regularly elicit the rare phenomenon of referred cramping phantom pain by touching the face. To clarify the underlying mechanisms, we followed the cramp during the course of an axillary blockade of the brachial plexus. During the blockade, both phantom pain and the referred cramp were abolished, while a referred sensation of "being touched at the phantom" persisted...
April 17, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/29659438/selective-suprascapular-and-axillary-nerve-block-versus-interscalene-plexus-block-for-pain-control-after-arthroscopic-shoulder-surgery-a-noninferiority-randomized-parallel-controlled-clinical-trial
#9
Anneleen Neuts, Björn Stessel, Patrick F Wouters, Carl Dierickx, Wilfried Cools, Jean-Paul Ory, Jasperina Dubois, Luc Jamaer, Ingrid Arijs, Dirk Schoorens
BACKGROUND AND OBJECTIVES: This randomized trial aimed to assess if a combined suprascapular-axillary nerve block (SSB) is noninferior (margin = 1.3 on a 0- to 10-point scale) to interscalene block (ISB) in treating pain after arthroscopic shoulder surgery. Secondary end points included opioid consumption, dyspnea, discomfort associated with muscle weakness, and patient satisfaction. METHODS: One hundred patients undergoing arthroscopic shoulder surgery were randomized to receive ultrasound-guided ISB (n = 50) or SSB (n = 50)...
April 14, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29657704/successful-treatment-of-three-synchronous-primary-malignant-tumours-reflection-on-surgical-pathological-and-oncological-aspects-and-decision-making
#10
Emese Irma Ágoston, Áron Somorácz, Lilla Madaras, Attila Zaránd, Gyöngyvér Szentmártoni, Zsuzsanna Orosz, Magdolna Dank, Zsolt Baranyai
We report a case of a patient with triple synchronous primary malignancies (breast, colon, kidney) which has not been previously reported in the literature. A 70-year-old woman was diagnosed with invasive ductal carcinoma of the left breast with axillary lymph node metastasis. During the staging period, renal cell carcinoma on the left kidney and mucinous adenocarcinoma in the proximal colon were found. Since the breast tumour demonstrated favourable biology, aromatase inhibitor therapy had been started and simultaneous right colectomy and left nephrectomy was performed...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29643620/opioid-free-anesthesia-for-breast-cancer-surgery-an-observational-study
#11
Swagata Tripathy, Satyajit Rath, Suresh Agrawal, P Bhaskar Rao, A Panda, T S Mishra, Sukdev Nayak
Background and Aims: Opioids are associated with postoperative nausea, vomiting, drowsiness, and increased analgesic requirement. A nonopioid anesthesia technique may reduce morbidity, enable day care surgery, and possibly decrease tumor recurrence. We compared opioid-free, nerve block-based anesthesia with opioid-based general anesthesia for breast cancer surgery in a prospective cohort study. Material and Methods: Twenty four adult American Society of Anesthesiologists grade I-III patients posted for modified radical mastectomy (MRM) with axillary dissection were induced with propofol and maintained on isoflurane (0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29630033/a-randomized-comparison-between-interscalene-and-small-volume-supraclavicular-blocks-for-arthroscopic-shoulder-surgery
#12
Julián Aliste, Daniela Bravo, Diego Fernández, Sebastián Layera, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)-guided interscalene block (ISB) and small-volume supraclavicular block (SCB) for arthroscopic shoulder surgery. We hypothesized that SCB would provide equivalent analgesia to ISB 30 minutes after surgery without the risk of hemidiaphragmatic paralysis (HDP). METHODS: All patients received an US-guided intermediate cervical plexus block. In the ISB group, US-guided ISB was performed with 20 mL of levobupivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#13
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29601275/effects-of-conversational-hypnosis-on-relative-parasympathetic-tone-and-patient-comfort-during-axillary-brachial-plexus-blocks-for-ambulatory-upper-limb-surgery-a-quasiexperimental-pilot-study
#14
Emmanuel Boselli, Hervé Musellec, Franck Bernard, Nicolas Guillou, Pierre Hugot, Caroline Augris-Mathieu, Nathalie Diot-Junique, Lionel Bouvet, Bernard Allaouchiche
This two-center quasiexperimental pilot study was to determine the effect of conversational hypnosis on patient comfort and parasympathetic tone, which may represent a quantitative measure of hypnotic depth, during regional anesthesia. The patients received conversational hypnosis in one center and oral premedication in the other. The patients' subjective comfort (0-10 rating scale) and objective parasympathetic tone, as assessed by the Analgesia/Nociception Index (ANI), were measured before and after regional anesthesia...
April 2018: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/29589414/comparison-of-axillary-nerve-block-duration-using-mepivacaine-in-non-insulin-diabetic-or-renal-insufficiency-patients-a-controlled-observational-matched-multicentre-trial
#15
Philippe Cuvillon, Melissa Casier, Christophe Demattei, Nathalie Bernard, Christophe Boisson, Nathalie Vialles, Joel Lhermite, Jacques Ripart, Xavier Capdevila
BACKGROUND: Although studies in diabetic patients demonstrated delayed recovery after long-acting local anesthetic, its effects with short-acting LA remains to be determined. Using mepivacaine, the authors evaluated the duration of axillary nerve blocks in diabetic (DP), renal failure (creatinine clearance < 30 ml.min-1) (RP) and healthy patients (HP). METHOD: We prospectively included consecutive patients aged 18-80 years, with DP (n=37), RP (n=32) and HP (n=48) scheduled for distal upper limb surgery...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29561543/ultrasound-guided-axillary-tunnel-block-revisited
#16
LETTER
Phillip Cornish
No abstract text is available yet for this article.
April 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29541238/effects-of-general-anesthesia-with-or-without-epidural-block-on-tumor-metastasis-and-mechanisms
#17
Bin Yang, Feng Qian, Wenjia Li, Yang Li, Yangdong Han
The present study aimed to assess whether different anesthesia methods (general anesthesia and general anesthesia combined with epidural block) were associated with tumor metastasis during the perioperative period and the possible molecular mechanisms of tumor metastasis. A rat hepatoma tumor xenograft model was constructed via the subcutaneous injection of Morris hepatoma 3924A cells into the upper axillary fossa. General anesthesia and general anesthesia combined with epidural block prior to hepatectomy were conducted on tumor-bearing rats...
April 2018: Oncology Letters
https://www.readbyqxmd.com/read/29511891/diaphragmatic-paralysis-in-obese-patients-in-arthroscopic-shoulder-surgery-consequences-and-causes
#18
Philippe Marty, Fabrice Ferré, Bertrand Basset, Constance Marquis, Benoit Bataille, Martine Chaubard, Mehdi Merouani, Olivier Rontes, Alain Delbos
PURPOSE: Ambulatory process in arthroscopic shoulder surgery has boomed over past decades. Some anesthetic techniques such as interscalene block (ISB) and its surrogates are associated with diaphragmatic paralysis and might compromise outpatient procedure. HYPOTHESIS: This study aims to assess consequences of diaphragmatic paralysis in obese patients. METHODS: This prospective observational study screened patients with body mass index (BMI) ≥ 30 kg/m2 undergoing acromioplasty or supraspinatus tendon repair...
March 6, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29457120/spread-of-injectate-in-ultrasound-guided-serratus-plane-block-a-cadaveric-study
#19
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
Background: Serratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection. Findings: Ultrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers...
2018: JA clinical reports
https://www.readbyqxmd.com/read/29456706/comparison-of-single-and-triple-injection-methods-for-ultrasound-guided-interscalene-brachial-plexus-blockade
#20
Cun-Jin Wang, Ya-Li Ge, Ju Gao, Feng-Yun Long, Zhi-Hua Mi, Tian-Feng Huang, Xiang-Zhi Fang, Xiao-Ping Chen, Yu-Si Hua, Yang Zhang
Ultrasound-guided interscalene brachial plexus blockade (IBPB) has a relatively high success rate in shoulder surgery; however, whether multiple injections are superior to a single injection (SI) is currently unknown. In the present study, ultrasound-guided SI and triple-injection (TI) IBPBs were compared in a prospective randomized trial. A total of 111 patients undergoing arthroscopic shoulder surgery and presenting with an American Society of Anesthesiologists physical status grading of I-II were randomly allocated to receive IBPB with 15 ml of 1% ropivacaine as a SI or TI...
March 2018: Experimental and Therapeutic Medicine
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