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Mastectomy pain

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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/29772993/shoulder-lesion-in-a-69-year-old-woman
#2
Andrew J Hayden, Srinivas Kolla, Adele L Boskey, Steven Burekhovich, Chuanyong Lu, Michael Stracher, Aditya V Maheshwari
Milwaukee Shoulder Syndrome (MSS) is a painful progressive arthropathy in which hydroxyapatite crystal deposition in synovial tissue induces lysosomal release of collagenase and neutral proteases. These enzymes are destructive to periarticular tissue, including the synovium, articular cartilage, rotator cuff muscles, and the intrasynovial cortical bone. MSS predominantly occurring in women (90%) over the age of 70 years of age with a clinical history marked by recurrent joint effusions and pain, which classically worsens at night...
2018: Journal of Long-term Effects of Medical Implants
https://www.readbyqxmd.com/read/29764822/numb-chin-syndrome-an-ominous-sign-of-mandibular-metastasis
#3
Abdul Razak, Bee See Goh, Jothi Raamahlingam Rajaran, Abd Jabar Nazimi
A 51-year-old woman a known case of stage 2 breast carcinoma in 2006 and underwent left mastectomy performed in the same year presented with bilateral lower limb pain suggestive of spinal pathology, and left chin numbness, both of 2 weeks' duration. Examination revealed left mandibular hypoesthesia without any other sign or symptoms. Orthopantomogram was unremarkable apart from mild alveolar bone expansion at tooth 36 area, which was extracted 3 months earlier. Subsequently, a full-body positron emission tomography contrast enhanced computer tomography revealed hypermetabolic lesions of her axial (excluding skull) and appendicular skeleton...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29741462/complications-risk-factors-and-patients-reported-outcomes-after-skin-sparing-mastectomy-followed-by-breast-reconstruction-in-women-with-brca-mutations
#4
Ingvild O Moberg, Inger Schou Bredal, Michael R Schneider, Kim A Tønseth, Ellen Schlichting
BACKGROUND: Women with a BRCA mutation have the option of undergoing prophylactic mastectomy and immediate breast reconstruction; however, the potential negative effects of reconstruction on women's physical and psychological well-being are unclear. This study aimed to investigate complications, patient-reported pain, health-related quality-of-life (HRQoL) and satisfaction following reconstructive surgery at Oslo University Hospital between 2006 and 2013. METHODS: Data were collected retrospectively from the records of 238 patients...
May 9, 2018: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/29727875/-adenocarcinoma-of-the-mamma-in-a-g%C3%A3-ttingen-minipig
#5
Marlene Töpfer, Bernadette Hinzmann, Olivia Kershaw, Karl Heinz Lahrmann
In this report, the case of a tumourous enlargement of the mammary gland of a 10-year-old, female, Göttingen minipig is described. Noticeable clinical signs were an inflammatory enlargement of one complex of the mammary gland with a teat lesion and a foul-odour, liquid secretion. Further symptoms included reduced general health, with expression of pain, loss of appetite and dehydration. Mastectomy with histopathological examination of the tissue led to the diagnosis of an adenocarcinoma. The pig recovered without complications and was free of symptoms 6 months later...
April 2018: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/29721811/life-quality-of-patients-who-underwent-breast-reconstruction-after-prophylactic-mastectomy-systematic-review
#6
REVIEW
Dilek Aygin, Hande Cengiz
BACKGROUND: Prophylactic mastectomy is used to reduce the incidence of breast cancer in women with genetic predisposition and family history of breast cancer, and the rate of application is increased nowadays. Chronic pain, body image, and sexuality may negatively affect quality of life, while patients generally have increased quality of life and satisfaction after prophylactic mastectomy. The aim of this study is the evaluation of the results of the studies about quality of life of patients who underwent breast reconstruction after prophylactic mastectomy...
May 2, 2018: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/29720754/effects-of-adding-dexamethasone-or-ketamine-to-bupivacaine-for-ultrasound-guided-thoracic-paravertebral-block-in-patients-undergoing-modified-radical-mastectomy-a-prospective-randomized-controlled-study
#7
Mona Blough El Mourad, Asmaa Fawzy Amer
Background and Aims: Pain after modified radical mastectomy (MRM) has been successfully managed with thoracic paravertebral block (TPVB). The purpose of this study was to evaluate the effect of adding dexamethasone or ketamine as adjuncts to bupivacaine in TPVB on the quality of postoperative analgesia in participants undergoing MRM. Methods: This prospective randomised controlled study enrolled ninety adult females scheduled for MRM. Patients were randomised into three groups (30 each) to receive ultrasound-guided TPVB before induction of general anaesthesia...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29703097/the-sex-life-of-women-surviving-breast-cancer
#8
Anna Ghizzani, Simone Bruni, Stefano Luisi
The diagnosis of breast cancer elicits diverse emotional responses in patients and partners. Surviving cancer has raised new needs and caretakers must understand the medical and psychological latent effects of oncology therapy. Improving patients' well-being is crucial as 19 million survivors are expected in the next decade in the United States alone. In general, sexuality contributes to one's well-being but when it is disrupted by the occurrence of cancer, women withdraw emotionally, no longer feel desirable due to esthetic damage, and become overwhelmed by the thought of sex...
April 27, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29697602/a-prospective-comparison-of-short-term-outcomes-of-subpectoral-and-prepectoral-strattice-based-immediate-breast-reconstruction
#9
Benjamin G Baker, Renu Irri, Vivienne MacCallum, Rahul Chattopadhyay, John Murphy, James R Harvey
BACKGROUND: Prepectoral acellular dermal matrix-assisted immediate implant-based breast reconstruction is gaining popularity, involving complete implant coverage with acellular dermal matrix. The authors aimed to compare pain, patient-reported outcome measures (including implant rippling), and safety of prepectoral and subpectoral Strattice-assisted implant-based breast reconstruction. METHODS: Consecutive patients were recruited prospectively, having either therapeutic or risk-reducing mastectomy...
May 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29692660/the-satisfaction-of-patients-with-breast-cancer-undergone-immediate-reconstruction-with-implant-and-the-effect-of-radiotherapy
#10
Ayse Y Altinok, Nuran Bese, Halil Kara, Sukru Yazar, Cihan Unal
Aim of the study: Postmastectomy reconstructive surgery for cosmetic satisfaction of patients is rapidly increasing. Postoperative complications such as infection, capsular contracture, implant loss are more common in patients who receive adjuvant radiotherapy (RT) than those who do not. Satisfaction levels in patients is still a controversial issue. Therefore, we wanted to investigate our patient population for the effects of RT and planned a study evaluating the satisfaction rates of our patients who received implants...
2018: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/29688930/the-erector-spinae-plane-block-provides-complete-surgical-anesthesia-in-breast-surgery-a-case-report
#11
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
#12
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/29661153/improved-analgesia-and-reduced-post-operative-nausea-and-vomiting-after-implementation-of-an-enhanced-recovery-after-surgery-eras-pathway-for-total-mastectomy
#13
Catherine Chiu, Pedram Aleshi, Laura J Esserman, Christina Inglis-Arkell, Edward Yap, Elizabeth L Whitlock, Monica W Harbell
BACKGROUND: Enhanced Recovery After Surgery (ERAS) pathways have been shown in multiple surgical disciplines to improve outcomes, including reduced opioid consumption, length of stay, and post-operative nausea and vomiting (PONV). However, very few studies describe the application of ERAS to breast surgery and even fewer describe ERAS for outpatient surgery. We describe the implementation and efficacy of an Enhanced Recovery After Surgery (ERAS) pathway for total skin-sparing mastectomy with immediate reconstruction in an outpatient setting...
April 16, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29659182/ropivacaine-wound-infiltration-for-pain-management-after-breast-cancer-mastectomy-a-population-pharmacokinetic-analysis
#14
Camille Riff, Romain Guilhaumou, Amelie Marsot, Marc Beaussier, Monique Cohen, Olivier Blin, Daniel Francon
Ropivacaine continuous wound infusions (CWIs) are extensively used as a component of multimodal analgesia. The rational application of CWI of ropivacaine requires a thorough understanding of its pharmacokinetics to investigate the risk of potential systemic toxicity. A population pharmacokinetic (popPK) study was undertaken to describe the pharmacokinetics of ropivacaine CWI during 75 hours. Women undergoing a unilateral mastectomy were scheduled to receive CWI for 40 hours for postoperative analgesia. A 10-mL ropivacaine 0...
April 16, 2018: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/29643620/opioid-free-anesthesia-for-breast-cancer-surgery-an-observational-study
#15
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/29577505/efficacy-and-safety-of-bilateral-thoracic-paravertebral-blocks-in-outpatient-breast-surgery
#16
Linden K Head, Anne Lui, Kirsty Usher Boyd
Unilateral thoracic paravertebral blocks (TPVBs) have demonstrated reliable intraoperative analgesia, low postoperative pain scores, and an opioid-sparing effect in breast cancer surgery. However, secondary to the perceived risk of complications, bilateral TPVB have been less well accepted and are less frequently used. The purpose of this study was to evaluate the feasibility of using bilateral TPVBs in outpatient surgery for patients undergoing bilateral mastectomy with immediate implant-based reconstruction...
March 25, 2018: Breast Journal
https://www.readbyqxmd.com/read/29565951/effect-of-dexmedetomidine-added-to-modified-pectoral-block-on-postoperative-pain-and-stress-response-in-patient-undergoing-modified-radical-mastectomy
#17
Mohamed A Bakr, Sahar A Mohamed, Mohamad F Mohamad, Montaser A Mohamed, Fatma A El Sherif, Eman Mosad, Mohammed F Abdel-Hamed
BACKGROUND: The most common surgical procedure for breast cancer is the modified radical mastectomy (MRM), but it is associated with significant postoperative pain. Regional anesthesia can reduce the stress response associated with surgical trauma. OBJECTIVES: Our aim is to explore the efficacy of 1 µg/kg dexmedetomedine added to an ultrasound (US)-modified pectoral (Pecs) block on postoperative pain and stress response in patients undergoing MRM. STUDY DESIGN: A randomized, double-blind, prospective study...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29520501/feasibility-study-of-contralateral-risk-reducing-mastectomy-with-breast-reconstruction-for-breast-cancer-patients-with-brca-mutations-in-japan
#18
Akiyo Yoshimura, Seiko Okumura, Masataka Sawaki, Masaya Hattori, Junko Ishiguro, Yayoi Adachi, Haruru Kotani, Naomi Gondo, Ayumi Kataoka, Madoka Iwase, Sakura Onishi, Kayoko Sugino, Mitsuo Terada, Nanae Horisawa, Makiko Mori, Nobue Takaiso, Ikuo Hyodo, Hiroji Iwata
BACKGROUND: Contralateral risk-reducing mastectomy (CRRM) for breast cancer patients with BRCA mutations has been reported to not only reduce breast cancer incidence but also to improve survival. The National Comprehensive Cancer Network guidelines recommend providing CRRM to women with BRCA mutations who desire CRRM after risk-reduction counseling. However, in Japan, CRRM cannot be performed generally because it is not covered by health insurance. Thus, we conducted a feasibility study to confirm the safety of CRRM...
March 8, 2018: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/29516364/associations-between-sentinel-lymph-node-biopsy-and-complications-for-patients-with-ductal-carcinoma-in-situ
#19
Brigid K Killelea, Jessica B Long, Weixiong Dang, Sarah S Mougalian, Suzanne B Evans, Cary P Gross, Shi-Yi Wang
PURPOSE: To examine the associations between sentinel lymph node biopsy (SLNB) and complications among older patients who underwent breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). METHODS: We identified women from the Surveillance, Epidemiology, and End Results-Medicare dataset aged 67-94 years diagnosed during 1998-2011 with DCIS who underwent BCS as initial treatment. We assessed incidence of complications, including lymphedema, wound infection, seroma, or pain, within 9 months of diagnosis...
June 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29481391/intraoperative-nerve-blocks-fail-to-improve-quality-of-recovery-after-tissue-expander-breast-reconstruction-a-prospective-double-blinded-randomized-placebo-controlled-clinical-trial
#20
Steven T Lanier, Kevin C Lewis, Mark C Kendall, Brittany L Vieira, Gildasio De Oliveira, Anthony Nader, John Y S Kim, Mohammed Alghoul
BACKGROUND: The authors' study represents the first level I evidence to assess whether intraoperative nerve blocks improve the quality of recovery from immediate tissue expander/implant breast reconstruction. METHODS: A prospective, randomized, double-blinded, placebo-controlled clinical trial was conducted in which patients undergoing immediate tissue expander/implant breast reconstruction were randomized to either (1) intraoperative intercostal and pectoral nerve blocks with 0...
March 2018: Plastic and Reconstructive Surgery
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