Thoracic paravertebral block for breast surgery in a patient with myasthenia gravis

Oğuz, Selma; Kucuk, Canan; Eskiçırak, Erdal; Akaltan, Ali; Kuru, N.; Kadıoğulları, Nihal

doi:10.1007/s00540-007-0531-0

Cited by 10 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Analgesia in both our groups was clinically satisfactory, but patients given paravertebral analgesia had better outcomes, with less immediate postoperative pain, reflected by a reduction in VAS score of 21%.The intensity of pain in our study was broadly comparable with two randomized studies of paravertebral analgesia (with or without concomitant general anesthesia) versus general anesthesia alone [ 2 , 4 ].In an animal model, optimum postoperative analgesia independently reduced the metastatic burden in rats inoculated with breast adenocarcinoma cells following surgery[ 11 ], which informed our choice of the most intense pain in the immediate two postoperative hours as one of our primary outcome measures.…”

Section: Discussionsupporting

confidence: 71%

Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia after Breast Cancer Surgery: A Randomized, Controlled, Single-Center Trial

et al. 2015

View full text Add to dashboard Cite

ObjectivesThe contribution of ultrasound-assisted thoracic paravertebral block to postoperative analgesia remains unclear. We compared the effect of a combination of ultrasound assisted-thoracic paravertebral block and propofol general anesthesia with opioid and sevoflurane general anesthesia on volatile anesthetic, propofol and opioid consumption, and postoperative pain in patients having breast cancer surgery.MethodsPatients undergoing breast cancer surgery were randomly assigned to ultrasound-assisted paravertebral block with propofol general anesthesia (PPA group, n = 121) or fentanyl with sevoflurane general anesthesia (GA group, n = 126). Volatile anesthetic, propofol and opioid consumption, and postoperative pain intensity were compared between the groups using noninferiority and superiority tests.ResultsPatients in the PPA group required less sevoflurane than those in the GA group (median [interquartile range] of 0 [0, 0] vs. 0.4 [0.3, 0.6] minimum alveolar concentration [MAC]-hours), less intraoperative fentanyl requirements (100 [50, 100] vs. 250 [200, 300]μg,), less intense postoperative pain (median visual analog scale score 2 [1, 3.5] vs. 3 [2, 4.5]), but more propofol (median 529 [424, 672] vs. 100 [100, 130] mg). Noninferiority was detected for all four outcomes; one-tailed superiority tests for each outcome were highly significant at P<0.001 in the expected directions.ConclusionsThe combination of propofol anesthesia with ultrasound-assisted paravertebral block reduces intraoperative volatile anesthetic and opioid requirements, and results in less post operative pain in patients undergoing breast cancer surgery.Trial RegistrationClinicalTrial.gov NCT00418457

show abstract

Section: Discussionsupporting

confidence: 71%

Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia after Breast Cancer Surgery: A Randomized, Controlled, Single-Center Trial

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Brachial plexus blockade by infraclavicular and axillary approaches has been reported for surgical anesthesia [47,48]. Paravertebral nerve blocks (T1-6) have also been used as the primary anesthetic in a patient with myasthenia gravis undergoing mastectomy and axillary lymph node dissection [49]. Interestingly, the authors chose a paravertebral approach over a neuraxial technique to provide unilateral blockade without sympathectomy and hypotension.…”

Section: Myasthenia Gravismentioning

confidence: 97%

“…Interestingly, the authors chose a paravertebral approach over a neuraxial technique to provide unilateral blockade without sympathectomy and hypotension. However, they did note a mild forced vital capacity decrease [49].…”

Section: Myasthenia Gravismentioning

confidence: 97%

Regional anesthesia in patients with pre-existing neurologic disease

McSwain

Doty

Wilson

2014

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

show abstract

“…44 TPVB has been performed for the patient with myasthenia gravis rather than general anesthesia for breast surgery and it has been reported that the operation was completed without any complications. 45 For 24-years-old pregnant patient at 19 gestational weeks has been performed TPVB due to axillary lymph node dissection and left breast tumor excision and it has been reported that the operation was completed without any complications by providing a perfect surgical environment. 46…”

Section: Anesthesia For Breast Surgerymentioning

confidence: 99%

Thoracal paravertebral block for breast surgery

Beyaz¹

2012

DMJ

View full text Add to dashboard Cite

Torakal paravertebral blok (TPVB), dengeli hemodinamik yanıtla seyreden güvenli bir anestezi sağlaması, kateter aracılığıyla postoperatif ağrı kontrolüne imkân vermesi ve düşük yan etki profili nedeniyle genel anesteziye alternatif bir yöntemdir. Meme kanser cerahisi geçiren olgularda da aynı nedenle güvenle uygulanabilir bir yöntem olan TPVB çok az merkezde genel anestezi yerine uygulanmaktadır. Meme cerrahisi altında hastalar için yeterli bir anestezi sağlamasının yanında, unilateral somatik ve sempatik blokaj ile stabil bir hemodinamik denge, mükemmele yakın postoperatif ağrı kontrolü, minimal bulantı-kusma oranı, erken taburculuk ve düşük maliyet sağlar. Bu nedenle bazı merkezlerde meme cerrahileri için standart bir yöntem olan torakal paravertebral blok tüm anestezistler tarafından bilinmelidir. Torakal paravertebral bloğun genel anestezinin yerine uygulanacak bir yöntem olduğu kanaatindeyiz.

show abstract

Thoracic paravertebral block for breast surgery in a patient with myasthenia gravis

Cited by 10 publications

References 5 publications

Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia after Breast Cancer Surgery: A Randomized, Controlled, Single-Center Trial

Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia after Breast Cancer Surgery: A Randomized, Controlled, Single-Center Trial

Regional anesthesia in patients with pre-existing neurologic disease

Thoracal paravertebral block for breast surgery

Contact Info

Product

Resources

About