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Post operative pain in mastectomy patients

G Militello, P De Marco, N Falco, K Kabhuli, A Mascolino, L Licari, R Tutino, G Cocorullo, G Gulotta
BACKGROUND: The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique. PATIENTS AND METHODS: From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection...
November 2016: Il Giornale di Chirurgia
D Nishimura, S Kosugi, Y Onishi, N Ihara, K Wakaizumi, H Nagata, T Yamada, T Suzuki, S Hashiguchi, H Morisaki
BACKGROUND: This prospective study was designed to examine the associations of demographic, clinical, psychological and neuroendocrine factors with acute and chronic post-operative pain following partial mastectomy. METHODS: Sixty-four female patients scheduled for partial mastectomy were enrolled. Pre-operative anxiety/depression was assessed, using the Hospital Anxiety and Depression Scale (HADS). Pre-operative 24-h urinary cortisol levels were measured 2 days before surgery...
February 7, 2017: European Journal of Pain: EJP
Luca Sorrentino, Salvatore Piraneo, Eliana Riggio, Silvia Basilicò, Alessandra Sartani, Daniela Bossi, Fabio Corsi
AIM: This study aimed to evaluate the benefits of Arnica montana on post-operative blood loss and seroma production in women undergoing unilateral total mastectomy by administering Arnica Montana 1000 Korsakovian dilution (1000 K). MATERIALS AND METHODS: From 2012 to 2014, 53 women were randomly assigned to A. montana or placebo and were followed up for 5 days. The main end point was the reduction in blood and serum volumes collected in drainages. Secondary end points were duration of drainage, a self-evaluation of pain, and the presence of bruising or hematomas...
January 2017: Journal of Intercultural Ethnopharmacology
Daniele Bordoni, Pierfrancesco Cadenelli, Nicola Rocco, Ariel Tessone, Giuseppe Falco, Cesare Magalotti
INTRODUCTION: The demand for reconstructive breast surgery after mastectomy is increasing among women and the two-stage option remains the most commonly performed technique. We conducted a self-controlled prospective clinical trial comparing the use of the serratus anterior fascia with the serratus anterior detached fibers to cover the inferolateral aspect of the expander in immediate two-stage breast reconstruction following conservative mastectomies as oncological or risk-reducing procedures...
February 2017: Aesthetic Plastic Surgery
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
Ambrose Rukewe, Oludolapo O Afuwape, Austin Ugheoke, Akinola A Fatiregun
We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. She declined general anesthesia and consented for TPVB. The surgery lasted 95 minutes and was successfully completed with TPVB...
2016: Local and Regional Anesthesia
Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
Clemens B Tempfer, Nariman El Fizazi, Hassan Ergonenc, Wiebke Solass
Metastasis of ovarian cancer to the breast (MOCB) is a rare event. Clinical presentations of MOCB vary and surgery is the mainstay of treatment. The current study presents two cases of MOCB in women with recurrent ovarian cancer first diagnosed in April 2011 and October 2013, respectively. The patients presented to the clinic with a localized, palpable, painful mass in the upper outer quadrant of the right breast and a centrally localized, palpable, painful mass of the left breast, respectively. Breast sonography and mammography showed a singular, round, homogenous tumor with irregular borders in each case...
June 2016: Oncology Letters
S M Nieves Maldonado, V Pubul Núñez, S Argibay Vázquez, M Macías Cortiñas, Á Ruibal Morell
A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions...
September 2016: Revista Española de Medicina Nuclear e Imagen Molecular
A Khan, J Zhang, V Sollazzo, K Mohammed, G Gui
BACKGROUND: Comprehensive studies of somatosensory change following breast reconstruction are limited. We investigated altered sensation quantitatively and qualitatively in patients undergoing mastectomies for cancer treatment and unaffected individuals who had risk-reducing mastectomies (RRM) for cancer predisposing genes. METHODS: Women attending breast clinic review at Royal Marsden Hospital, London were invited to participate. Sensory testing was performed a minimum of 1 year after surgery...
July 2016: European Journal of Surgical Oncology
Takahiro Nonaka, Marie Hara, Chisato Miyamoto, Michiko Sugita, Tatsuo Yamamoto
OBJECTIVE: Acetaminophen is known to be a relatively weak analgesic with fewer side effects than nonsteroidal anti-inflammatory drugs (NSAIDs). This study aimed to determine whether intravenous (iv) acetaminophen produces comparable analgesic effects to those of flurbiprofen (positive control drug), an intravenously injectable NSAID, after partial mastectomies. The primary outcome assessed was pain intensity during the first 24 h after the operation, and the secondary outcome was the satisfaction rating at discharge...
2016: Journal of Anesthesia
A Apte, M Walsh, S Chandrasekharan, A Chakravorty
INTRODUCTION: Acellular Dermal Matrix (ADM) assisted breast reconstruction has transformed the single-stage Immediate Breast Reconstruction (IBR) with an impact on the cosmetic outcomes. However, there is limited data available on patient reported outcomes. This study highlights the Patient Reported Outcome Measures (PROMs), post-operative complications and lessons learnt from ADM assisted single-stage immediate breast reconstruction. METHODS: This prospective study enrolled consecutive patients from Feb 2012 - May 2015 undergoing mastectomy with direct-to-implant ADM assisted breast reconstruction, using Strattice™ (Acelity, San Antonio, TX, USA)...
January 2016: European Journal of Surgical Oncology
Jean A O'Toole, Chantal M Ferguson, Meyha N Swaroop, Nora Horick, Melissa N Skolny, Cheryl L Brunelle, Cynthia L Miller, Lauren S Jammallo, Michelle C Specht, Alphonse G Taghian
We sought to assess the association of breast cancer-related lymphedema (BCRL) with the ability to perform upper extremity activities of daily living (ADL) in our patient population. 324 breast cancer patients who had received treatment for unilateral breast cancer at our institution between 2005 and 2014 were prospectively screened for lymphedema. Bilateral arm measurements were performed pre-operatively and during post-operative follow-up using a Perometer. Patients completed an extensive quality of life (QOL) questionnaire at the time of each study assessment...
April 2015: Breast Cancer Research and Treatment
S R Humble, A J Dalton, L Li
BACKGROUND: Perioperative neuropathic pain is under-recognized and often undertreated. Chronic pain may develop after any routine surgery, but it can have a far greater incidence after amputation, thoracotomy or mastectomy. The peak noxious barrage due to the neural trauma associated with these operations may be reduced in the perioperative period with the potential to reduce the risk of chronic pain. DATABASES AND DATA TREATMENT: A systematic review of the evidence for perioperative interventions reducing acute and chronic pain associated with amputation, mastectomy or thoracotomy...
April 2015: European Journal of Pain: EJP
Ian Campbell, Shelley Cavanagh, Jane Creighton, Rowan French, Shramana Banerjee, Emily Kerr, Rachel Shirley
BACKGROUND: There is limited evidence to support use of local anaesthetic (LA) wound infiltration in breast surgery. This study seeks to examine whether wound infiltration of bupivacaine (0.25%) decreases post-operative pain and analgesic use, without increasing post-operative complications. METHODS: A prospective single-blind study was undertaken of 90 patients undergoing breast lump excision, wide local excision and mastectomy with or without axillary surgery...
May 2015: ANZ Journal of Surgery
N Byager, M S Hansen, O Mathiesen, J B Dahl
BACKGROUND: Wound infiltration with local anaesthetics is commonly used during breast surgery in an attempt to reduce post-operative pain and opioid consumption. The aim of this review was to evaluate the effect of wound infiltration with local anaesthetics compared with a control group on post-operative pain after breast surgery. METHODS: A systematic review was performed by searching PubMed, Google Scholar, the Cochrane database and Embase for randomised, blinded, controlled trials of wound infiltration with local anaesthetics for post-operative pain relief in female adults undergoing breast surgery...
April 2014: Acta Anaesthesiologica Scandinavica
Christian Compagnone, Eleonora Schiappa, Daniele Bellantonio, Gianluca Ghirardi, Elisabetta Rossini, Fernanda Tagliaferri, Guido Fanelli
Paravertebral block (PVB) has been proposed as an alternative to General anaesthesia (GA) for breast surgery. It provides good operative anaesthesia, good pain control with little adverse effects. Six women older than 80 year were selected. All patients were post-operatively interviewed about the presence of pain, nausea and vomiting. All patients declared absence of pain and nausea and that they were satisfied with the procedure. The use of PVB allows elderly patients to undergo ambulatory surgery for the treatment of breast cancer with satisfaction...
January 23, 2014: Acta Bio-medica: Atenei Parmensis
Pankaj Kundra, Ramesh Varadharajan, Kotteeswaran Yuvaraj, Stalin Vinayagam
BACKGROUND: Paravertebral and inter pleural blocks (IPB) reduce post-operative pain and decrease the effect of post-operative pain on lung functions after breast surgery. This study was designed to determine their effect on lung functions and post-operative pain in patients undergoing modified radical mastectomy. MATERIALS AND METHODS: A total of 120 American Society of Anesthesiologists physical status 1 and 2 patients scheduled to undergo breast surgery were randomly allocated to receive IPB (Group IPB, n = 60) or paravertebral block (PVB) (Group PVB, n = 60) with 20 ml of 0...
October 2013: Journal of Anaesthesiology, Clinical Pharmacology
Monisha Sudarshan, Andrea Petrucci, Sinziana Dumitra, Jodie Duplisea, Sharon Wexler, Sarkis Meterissian
We sought to study the impact of yoga therapy on anxiety, depression and physical health in breast cancer patients. Stage I-III post-operative breast cancer patients were recruited with twelve 1-h weekly yoga sessions completed with an experienced yoga instructor. Before and after each module completion, assessments were obtained with the Hospital Anxiety and Depression scale (HADS), the Dallas pain scale and shoulder flexibility measurements. Fourteen patients completed the entire yoga session with 42.8% having a total mastectomy and 15...
November 2013: Complementary Therapies in Clinical Practice
Gregory C Wilson, Ralph C Quillin, Dennis J Hanseman, Jaime D Lewis, Michael J Edwards, Elizabeth A Shaughnessy
PURPOSE: Neuropathic pain (NPP) following breast surgery extends morbidity in the postoperative period. The incidence and etiology of postoperative NPP remains unclear and under-reported in literature. This study aims to define the incidence of neuropathic pain following breast surgery and to identify patient characteristics that are predictors for developing postoperative NPP. METHODS: Consecutive female patients undergoing breast resection surgery over a 5-year period (2008-2012) with 1-year minimum follow-up were included in this single-center study...
October 2013: Annals of Surgical Oncology
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