The usefulness of interpectoral block as an analgesic technique in breast cancer surgery

Autor: R. Ortiz de la Tabla González, D. Moreno Rey, C. Pérez Naranjo, I. Sánchez Martín, M. Echevarría Moreno, P. Gomez Reja
Rok vydání: 2018
Předmět:
Zdroj: Revista Española de Anestesiología y Reanimación (English Edition). 65:188-195
ISSN: 2341-1929
DOI: 10.1016/j.redare.2017.11.017
Popis: Objective To compare the analgesic efficacy of continuous interpectoral block (CIPB) compared to intravenous analgesia ( IV ) after breast surgery. Material and method A prospective, comparative and randomised study of women aged from 18 to 75 years, ASA I - III , operated for breast cancer. In group 1 (CIPB) after general anaesthetic, an ultrasound-guided interpectoral catheter was placed and 30 ml of 0.5% ropivacaine was administered through it. In the event of an increase in heart rate and blood pressure >15% after the surgical incision, intravenous fentanyl 1 μg kg−1 was administered, repeating the dose as necessary. In the postoperative period, perfusion of ropivacaine 0.2% 5 ml h−1; with PCA bolus 5 ml/30 min was administered through the catheter for 24 h and rescue analgesia prescribed with 5 mg subcutaneous morphine chloride. In group 2 ( IV ), after induction of general anaesthesia, intravenous fentanyl was administered in the same way as in the other group. The patients received metamizole 2 g with dexketoprofen 50 mg and ondansetron 4 mg postoperatively followed by perfusion of metamizole 4%, tramadol 0.2% and ondansetron 0.08% 2 ml h−1; with PCA bolus 2 ml/20 min for 24 h. The same rescue analgesia was prescribed. The principal variables recorded were pain at rest and during movement, according to a simple verbal scale (VAS 0–10) and the rescue analgesia required on discharge from recovery, at 12 and at 24 h. Results 137 patients were included: 81 in group 1 (59.12%) and 56 in group 2 (40.87%). No significant differences were observed in the analgesia between either group, but differences were observed in the dose of intraoperative fentanyl (p Conclusions Both techniques provided effective postoperative analgesia, but the CIPB group required significantly less intraoperative fentanyl.
Databáze: OpenAIRE
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