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Mastectomy pain

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https://www.readbyqxmd.com/read/28721091/comparison-of-single-injection-ultrasound-guided-approach-versus-multilevel-landmark-based-approach-for-thoracic-paravertebral-blockade-for-breast-tumor-resection-a-retrospective-analysis-at-a-tertiary-care-teaching-institution
#1
Jagroop Singh Saran, Amie L Hoefnagel, Kristin A Skinner, Changyong Feng, Daryl Irving Smith
BACKGROUND: The role of thoracic paravertebral blockade (TPVB) in decreasing opioid requirements in breast cancer surgery is well documented, and there is mounting evidence that this may improve survival and reduce the rate of malignancy recurrence following cancer-related mastectomy. We compared the two techniques currently in use at our institution, the anatomic landmark-guided (ALG) multilevel versus an ultrasound-guided (USG) single injection, to determine an optimal technique. METHODS: We retrospectively reviewed records of patients who received TPVB from January 2013 to December 2014...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#2
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#3
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28691269/the-effect-of-intraoperative-systemic-lidocaine-on-postoperative-persistent-pain-using-immpact-criteria-assessment-following-breast-cancer-surgery-a-randomized-double-blind-placebo-controlled-trial
#4
Mark C Kendall, Robert J McCarthy, Steve Panaro, Emily Goodwin, Jane M Bialek, Antoun Nader, Gildasio De Oliveira
OBJECTIVE: To compare the incidence in postsurgical persistent pain following breast cancer surgery in women receiving intravenous lidocaine compared to saline using validated pain instruments in accordance with the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations. METHODS: The study was a randomized, double-blinded, placebo-controlled, clinical trial. Subjects were randomized into Group 1 (1.5 mg/kg bolus of intravenous lidocaine followed by a 2mg/kg/hr infusion) or Group 2 (normal saline at the same bolus and infusion rate)...
July 10, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28677010/preoperative-paravertebral-blocks-for-the-management-of-acute-pain-following-mastectomy-a-cost-effectiveness-analysis
#5
REVIEW
Anaeze C Offodile, Clifford C Sheckter, Austin Tucker, Anna Watzker, Kevin Ottino, Martin Zammert, William V Padula
PURPOSE: Preoperative paravertebral blocks (PPVBs) are routinely used for treating post-mastectomy pain, yet uncertainties remain about the cost-effectiveness of this modality. We aim to evaluate the cost-effectiveness of PPVBs at common willingness-to-pay (WTP) thresholds. METHODS: A decision analytic model compared two strategies: general anesthesia (GA) alone versus GA with multilevel PPVB. For the GA plus PPVB limb, patients were subjected to successful block placement versus varying severity of complications based on literature-derived probabilities...
July 4, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28664348/paravertebral-blocks-for-same-day-breast-surgery
#6
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/28654558/the-efficacy-of-ultrasound-guided-type-ii-pectoral-nerve-blocks-in-perioperative-pain-management-for-immediate-reconstruction-after-modified-radical-mastectomy-a-prospective-randomized-study
#7
Kaiyuan Wang, Xiaobei Zhang, Tingting Zhang, Hui Yue, Shan Sun, Hongwei Zhao, Peng Zhou
OBJECTIVES: The pectoral nerves (Pecs) II block is a technique that places local anesthetic between the thoracic muscles to block the axillary and breast regions. This study aimed to compare the quality of perioperative analgesia and side effects of the Pecs II block under general anesthesia versus general anesthesia alone in immediate unilateral breast reconstruction with an implant and latissimus dorsi (LD) flap after modified radical mastectomy. METHODS: Sixty-four patients scheduled for immediate breast reconstruction after modified radical mastectomy were randomly allocated into the Pecs II block under general anesthesia group (Group P, n=32) or the general anesthesia alone group (Group G, n=32)...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28643007/the-role-of-lipofilling-after-breast-reconstruction-evaluation-of-outcomes-and-patient-satisfaction-with-breast-q
#8
Annalisa Cogliandro, Mauro Barone, Stefania Tenna, Marco Morelli Coppola, Paolo Persichetti
INTRODUCTION: The aim of this study was to measure patient satisfaction using the BREAST-Q reconstruction module in patients selected for lipofilling procedures after implant breast reconstructions. MATERIALS AND METHODS: Seventy patients who underwent breast reconstruction with or without delayed lipofilling were enrolled between 2011 and 2015, and they completed BREAST-Q surveys. We administered the questionnaire electronically 6 months and 1 year after surgery...
June 22, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28637424/gabapentin-in-procedure-specific-postoperative-pain-management-preplanned-subgroup-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#9
Maria Louise Fabritius, Anja Geisler, Pernille Lykke Petersen, Jørn Wetterslev, Ole Mathiesen, Jørgen Berg Dahl
BACKGROUND: It has been argued that postoperative pain treatment should be "procedure-specific", since different analgesics may have specific effects dependent on the surgical procedure. The aim of the present subgroup analysis was to compare the beneficial and harmful effects of perioperative gabapentin treatment in different surgical procedures. METHODS: Relevant databases were searched for randomized clinical trials (RCTs) comparing gabapentin versus placebo...
June 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#10
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28605205/analysis-of-factors-influencing-drain-amount-time-to-drain-removal-and-seroma-formation-in-patients-undergoing-immediate-expander-implant-breast-reconstruction
#11
Kyong-Je Woo, Joo Myong Paik, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Sa Ik Bang
BACKGROUND: Placement of a closed suction drain is a common cause of patient complaints, such as postoperative pain or discomfort following immediate expander-implant breast reconstruction. This study aims to identify factors that affect drainage volume, time to drain removal, and seroma formation. METHODS: A retrospective chart review of prospectively collected data was conducted on patients who underwent immediate expander-implant breast reconstructions following nipple-sparing or skin-sparing mastectomy without skin excision (nipple areolar complex excision only) between February 2010 and April 2015...
June 12, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28601480/the-trajectory-of-postoperative-pain-following-mastectomy-with-and-without-paravertebral-block
#12
Rochelle Wynne, Natalie Lui, Kristen Tytler, Carol Koffsovitz, Victor Kirwa, Bernhard Riedel, Shane Ryan
Evidence to support the argument that general anesthesia (GA) with paravertebral block (PVB) provides better pain relief for mastectomy patients than GA alone is contradictory. The aim of this study was to explore pain and analgesia after mastectomy with or without PVB during acute inpatient recovery. A retrospective study was conducted in a single hospital providing specialist cancer services in metropolitan Melbourne, Australia. We explored pain and concomitant analgesic administration in 80 consecutive women recovering from mastectomy who underwent GA with (n = 40) or without (n = 40) PVB...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28584507/a-comparative-study-of-the-use-of-harmonic-scalpel-versus-unipolar-cautery-in-modified-radical-mastectomy
#13
Pallavi Mittal, Ashwani Kumar, Sunmeet Kaur, Paras Kumar Pandove, Rachan Lal Singla, Jagpal Singh
CONTEXT: Oncosurgery is an emerging branch with the set goals of prolonging the life and ensuring the best possible quality of life to the surviving patient. The use of harmonic scalpel has proved to be beneficial in a variety of surgeries but its role in breast surgery is still controversial. AIMS: We conducted this study to compare the intraoperative and postoperative outcomes in modified radical mastectomy using harmonic scalpel versus electrocautery. SUBJECTS AND METHODS: Fifty female patients with confirmed diagnosis of breast carcinoma and planned for modified radical mastectomy were taken up for surgery...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28584346/analgesic-efficacy-of-ultrasound-guided-paravertebral-block-versus-serratus-plane-block-for-modified-radical-mastectomy-a-randomised-controlled-trial
#14
Kapil Gupta, Kadapa Srikanth, Kiran Kumar Girdhar, Vincent Chan
BACKGROUND AND AIMS: Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB). METHODS: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28574950/prepectoral-breast-reconstruction-a-safe-alternative-to-submuscular-prosthetic-reconstruction-following-nipple-sparing-mastectomy
#15
Hani Sbitany, Merisa Piper, Rachel Lentz
BACKGROUND: Nipple sparing mastectomy (NSM) with immediate prosthetic reconstruction is routinely performed due to excellent aesthetic results, and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, due to pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major, by placing the prosthesis completely above the muscle with complete acellular dermal matrix (ADM) coverage...
May 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28560595/trends-in-sexual-function-after-breast-cancer-surgery
#16
Lauren F Cornell, Dawn M Mussallem, Tammeza C Gibson, Nancy N Diehl, Sanjay P Bagaria, Sarah A McLaughlin
PURPOSE: Sexual dysfunction is assumed to be common, but understudied, in breast cancer patients. Herein, we use the validated female sexual functioning index (FSFI) to evaluate changes in female sexual function after breast cancer surgery. METHODS: The FSFI assesses sexual function in six domains (desire, arousal, lubrication, orgasm, satisfaction, pain) on a 36-point scale, with scores >26.6 indicating better sexual function. We identified 226 women with unilateral breast cancer undergoing surgery at our institution from June 2010-January 2015...
May 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28558811/focal-necrosis-mimicking-breast-cancer-following-coronary-bypass-grafting
#17
Oldřich Coufal, Tomáš Ostřížek, Petr Krsička, Eva Lžičařová, Rudolf Nenutil, Monika Procházková, Beatrix Bencsiková, Peter Grell, Roman Šefr
BACKGROUND: Breast cancer can be diagnosed easily in most cases. However, occasionally, we are faced with some conditions that can mimic it. These may include inflammations, benign tumors, cysts, hematomas, or, more rarely, focal necrosis. CASE PRESENTATION: This report presents a case of focal breast necrosis following myocardial revascularization with the left internal mammary artery, which is a very rare condition, with only few cases described in the literature...
May 30, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28536526/dexmedetomidine-improves-postoperative-patient-controlled-analgesia-following-radical-mastectomy
#18
Wei Fan, Hong Xue, Yong Sun, HaiKou Yang, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Acute postoperative pain following radical mastectomy is a high risk for prolonged convalescence and potential persistent pain in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on acute postoperative pain following radical mastectomy under general anesthesia. Forty-five patients were enrolled into the study and divided into two groups that were maintained with propofol/remifentanil/Ringer's solution or propofol/remifentanil/Dexmedetomidine followed by morphine-based patient-controlled analgesia...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28529229/frances-burney-s-mastectomy-narrative-and-discourses-of-breast-cancer-in-the-long-eighteenth-century
#19
Heather Meek
This paper examines Frances Burney's 1812 mastectomy letter alongside contemporaneous medical treatises on the subject of breast cancer. Burney's letter offers a critique of a medical community that misconstrues her experience and can be viewed as pathography, or disability memoir. Examining the letter and the treatises in this way illuminates the brutality of some medical practices and the frequent incongruity between the patients' and the physicians' understandings of pain. However, the letter and the treatises also share much in common; both at times emphasize the patient's words and experiences, and both reveal the impressive and contradictory range of ideas surrounding breast cancer in the long eighteenth century...
2017: Literature and Medicine
https://www.readbyqxmd.com/read/28528191/subcutaneous-implant-breast-reconstruction-time-to-reconsider
#20
REVIEW
M-K Tasoulis, F M Iqbal, S Cawthorn, F MacNeill, R Vidya
Improvements in breast surgery techniques such as skin and nipple preserving mastectomy and innovative prosthetics (implants, acellular dermal matrices and meshes) is renewing interest in subcutaneous (pre-pectoral) implant reconstruction. The aim of this paper is to review the current literature in an attempt to provide a rationale that may support a return to subcutaneous implant placement, so minimising the pain and functional problems resulting from submuscular breast reconstruction.
May 4, 2017: European Journal of Surgical Oncology
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