Comparison between thoracic paravertebral block and segmental thoracic spinal anesthesia in breast cancer surgery

Mazy, Alaa; El-Domiaty, Ashraf; Mageed, Nabil A; Motawi, Abdel Aziz; Messeha, Medhat Mikhail

doi:10.1186/s42077-022-00281-8

Cited by 2 publications

(1 citation statement)

References 42 publications

(39 reference statements)

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“…In a different research by Mazy et al, when they compared the Thoracic Para vertebral block and Segmental thoracic spinal anesthesia (STSA) procedures for mastectomy, they found that the latter provided significant analgesia and a sufficient level of anesthesia with few complications. The STSA group's anesthesia required less fentanyl and was quicker, wider, and longer [14]. Muscle relaxation is therefore equivalent across the low and high dose groups during surgeries lasting roughly 90 min.…”

Section: Discussionmentioning

confidence: 87%

Comparison of Two Different Doses of Hyperbaric Bupivacaine in Segmental Spinal Anesthesia for Laparoscopic Cholecystectomy

BHALAVI

SHAKYA²,

Dandotiya³

2023

Asian J Pharm Clin Res

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Objective: Thoracic segmental anesthesia, as opposed to general anesthesia (GA), is increasingly preferred by anesthesiologists for laparoscopic cholecystectomy in both sick and healthy patients because it provides favorable operating conditions, a faster block time, and better hemodynamic stability. This study compared the efficacy of two different dosages of hyperbaric bupivacaine administered during segmental spinal anesthesia. Methods: In the current study, 54 American society of anesthesiologists Grade 1 and two patients undergoing elective laparoscopic cholecystectomy were randomly assigned to either Group A, which used 1.5 mL of hyperbaric bupivacaine mixed with 0.5 mL of fentanyl, or Group B, which used 2 mL of hyperbaric bupivacaine mixed with 0.5 mL of fentanyl. Primary objectives were to determine the onset and duration of the sensory and motor block, as well as height of sensory block. Determining the hemodynamic factors and complications were the secondary objectives. The mean, standard deviation, independent t test, Chi-square test, and p-value were used to calculate the data. p<0.05 was regarded as significant. Only some drugs were routinely given to the patient to manage their anxiety, discomfort, shoulder tip pain, etc., before, during, or after operation. Results: Onset of analgesia occurred in 2.5 min for Group A and 2.2 min for Group B. The sensory and motor blocks in Group B lasted longer than in Group A, but the differences were not statistically significant. No patients in either group reported any neurological complications, and there were no discernible differences between the two groups’ hemodynamic and respiratory dysfunctions. Despite some patients experiencing minor discomfort that was easily controlled by midazolam and ketamine in small doses, none of them required the conversion to GA. In two instances, Mephentermine was required to treat hypotension. In every patient, recovery went without a side effect. Conclusion: According to this preliminary study, laparoscopic surgery on healthy people can be performed with segmental spinal anesthesia using low doses of bupivacaine that is just as effective as high doses and present fewer complications.

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Section: Discussionmentioning

confidence: 87%

Comparison of Two Different Doses of Hyperbaric Bupivacaine in Segmental Spinal Anesthesia for Laparoscopic Cholecystectomy

BHALAVI

SHAKYA²,

Dandotiya³

2023

Asian J Pharm Clin Res

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Efficacy of Thoracic Segmental Spinal Anesthesia Along With Unilateral Erector Spinae Block in Patients Undergoing Unilateral Modified Radical Mastectomy and Axillary Dissection: A Novel Multicentric Study

Deshpande

Agarwal

HATGAONKAR³

et al. 2023

Asian J Pharm Clin Res

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Objectives: The aim of the study was to find out the efficacy of thoracic segmental spinal anesthesia combined with unilateral erector spinae block in patients undergoing unilateral modified radical mastectomy and axillary lymph node dissection Methods: This was a prospective cohort study in which 40 patients with carcinoma breast undergoing modified radical mastectomy with axillary dissection under thoracic segmental spinal anesthesia combined with unilateral erector spinae block were included on the basis of a predefined inclusion and exclusion criteria. Erector spinae plane block was given at T5 level and thoracic spinal anesthesia was then given at T5–T6 level in the same position by median or paramedian technique. Patients were assessed for severity of pain by visual analog scale score till 24 h of surgery. Results: The mean age of studied cases was found to be 44.12±10.04 years. Mean weight of studied cases was 54.38±9.8 kg, whereas mean duration of surgery was found to be 98.24±16.86 min. The most common American Society of Anesthesiologists (ASA) grade to which patients belonged was found to be ASA III (55%) followed by ASA II (30%) and ASA I (15%). Eleven patients required rescue analgesia within first 24 h after surgery and mean doses of rescue analgesia in 1st 24 h after surgery was found to be 0.92±0.48. Four (10%) patients developed hypotension, whereas three (7.5%) patients had bradycardia. However, all these 7 (17.5%) had transient bradycardia or hypotension which could be managed by IV Atropine or IV mephentermine and fluid bolus. Conclusion: Thoracic segmental spinal anesthesia combined with unilateral erector spinae block is an excellent option for patients undergoing modified radical mastectomy with axillary dissection.

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Comparison between thoracic paravertebral block and segmental thoracic spinal anesthesia in breast cancer surgery

Cited by 2 publications

References 42 publications

Comparison of Two Different Doses of Hyperbaric Bupivacaine in Segmental Spinal Anesthesia for Laparoscopic Cholecystectomy

Comparison of Two Different Doses of Hyperbaric Bupivacaine in Segmental Spinal Anesthesia for Laparoscopic Cholecystectomy

Efficacy of Thoracic Segmental Spinal Anesthesia Along With Unilateral Erector Spinae Block in Patients Undergoing Unilateral Modified Radical Mastectomy and Axillary Dissection: A Novel Multicentric Study

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