Paravertebral Blockade for Day-Case Breast Augmentation
| Autor: | Glenda E. Rudkin, John Field, Rodney D. Cooter, Sarah Gardiner, Malcolm J. Bond |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
medicine.medical_specialty Visual analogue scale Mammaplasty Sedation law.invention Young Adult Randomized controlled trial law Preoperative Care medicine Humans Ropivacaine Single-Blind Method Prospective Studies Anesthetics Local Breast augmentation Pain Postoperative business.industry Nerve Block Amides Surgery Plastic surgery Anesthesiology and Pain Medicine Ambulatory Surgical Procedures Anesthesia Anesthesia Intravenous Female medicine.symptom business Propofol Postoperative nausea and vomiting medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 115:1053-1059 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/ane.0b013e318264ba33 |
| Popis: | BACKGROUND Bilateral breast augmentation is an increasingly popular day-case procedure. Local infiltration with sedation is routinely used for its ease of application compared with the more complex and potentially riskier paravertebral blockade (PVB). We hypothesized that ropivacaine injected by experienced anesthesia providers into the paravertebral space as a PVB was more effective than ropivacaine injected by the operating surgeon (plastic surgeon) directly into the zone of surgical dissection. METHODS Forty female patients who were ASA physical status I or II and undergoing bilateral subpectoral cosmetic breast augmentation were recruited for participation in a prospective, randomized, single-blind study. Patients were randomized to 1 of 2 groups: ropivacaine via PVB, or surgical infiltration of ropivacaine. In both groups, the surgeon was asked to infiltrate the appropriate area with either saline (PVB group) or ropivacaine (local infiltration group). Both groups were sedated with propofol, titrated to effect. The plastic surgeon was blinded to the solution injected. Data collected included demographic characteristics, intraoperative cooperation scores, recovery room postoperative nausea and vomiting, analgesia use, and visual analog scale pain scores. All patients were asked to complete a preoperative anxiety and quality of recovery questionnaire and to record their pain scores and analgesia requirements on discharge. The outcome measures were (i) intraoperative patient cooperation as assessed by the plastic surgeon, (ii) propofol requirement, (iii) postoperative pain, and (iv) quality of recovery. RESULTS Forty patients completed the study. PVB improved intraoperative cooperation (significance of difference P < 0.001, WMWodds = 6.69 with 95% 1-sided confidence interval CI ≥2.85), reduced propofol requirement (significance of difference P = 0.005, WMWodds = 0.35, CI |
| Databáze: | OpenAIRE |
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