Post-mastectomy cancer recurrence with and without a continuous paravertebral block in the immediate postoperative period: a prospective multi-year follow-up pilot study of a randomized, triple-masked, placebo-controlled investigation
| Autor: | Finn, Daphna M, Ilfeld, Brian M, Unkart, Jonathan T, Madison, Sarah J, Suresh, Preetham J, Sandhu, Nav Parkash S, Kormylo, Nicholas J, Malhotra, Nisha, Loland, Vanessa J, Wallace, Mark S, Wen, Cindy H, Morgan, Anya C, Wallace, Anne M |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Clinical Trials and Supportive Activities Clinical Sciences Pain Breast Neoplasms Pilot Projects Double-Blind Method Clinical Research Anesthesiology Breast Cancer Humans Ropivacaine Postoperative Period Prospective Studies Anesthetics Local Postoperative Mastectomy Cancer recurrence Anesthetics Cancer Pain Postoperative Rehabilitation Evaluation of treatments and therapeutic interventions Nerve Block Continuous paravertebral block Middle Aged Amides Local 6.1 Pharmaceuticals Female Patient Safety Follow-Up Studies |
| Zdroj: | Journal of anesthesia, vol 31, iss 3 Finn, Daphna M; Ilfeld, Brian M; Unkart, Jonathan T; Madison, Sarah J; Suresh, Preetham J; Sandhu, Nav Parkash S; et al.(2017). Post-mastectomy cancer recurrence with and without a continuous paravertebral block in the immediate postoperative period: a prospective multi-year follow-up pilot study of a randomized, triple-masked, placebo-controlled investigation.. Journal of anesthesia, 31(3), 374-379. doi: 10.1007/s00540-017-2345-z. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/3sj5h948 |
| DOI: | 10.1007/s00540-017-2345-z. |
| Popis: | PurposeRetrospective studies have associated perioperative regional anesthesia/analgesia during mastectomy for breast cancer with a decreased incidence of cancer recurrence. However, to date, no prospective data from a randomized controlled trial have been reported. In a previous study we found that extending a single-injection paravertebral block with a multiple-day perineural local anesthetic infusion improves analgesia. This follow-up study investigates the rates of cancer recurrence for the single-injection and multiple-day infusion treatments.MethodsPatients undergoing unilateral (n=24) or bilateral mastectomy (n=36) were included in the study. All patients had been diagnosed with breast cancer or tumor in situ, except for six patients who were receiving prophylactic bilateral mastectomy and were excluded from analyses. Patients received unilateral or bilateral single-injection thoracic paravertebral block(s) corresponding to their surgical site(s) with ropivacaine and perineural catheter(s). Subsequently, patients were randomized to receive either ropivacaine 0.4% (n=30) or normal saline (n=30) via their catheter(s) until catheter removal on postoperative day 3. Cancer recurrence from the date of surgery until at least 2years post surgery was investigated via chart review.ResultsFive of the 54 (9.2%) patients experienced a cancer recurrence following mastectomy-3 of 26 (11.5%) of the patients with perineural ropivacaine and 2 of 28 (7.1%) of the patients with perineural saline.ConclusionsThis pilot study found no evidence that extending a single-injection paravertebral block with a multi-day perineural local anesthetic infusion decreases the risk of post-mastectomy cancer recurrence. However, due to the small sample size of this investigation, further research is needed to draw definitive conclusions. |
| Databáze: | OpenAIRE |
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