Evaluation of postoperative pain in patients undergoing modified radical mastectomy with pectoralis or serratus-intercostal fascial plane blocks
| Autor: | Kaur, Ushkiran, Shamshery, Chetna, Agarwal, Anil, Prakash, Neel, Valiveru, Ramya Chakrapani, Mishra, Prabhaker |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Nerve block Shoulder pain medicine.medical_treatment Modified radical mastectomy Analgesic Breast Neoplasms Intercostal Muscles Pectoralis muscle Intermediate Back Muscles Modified Radical Mastectomy Pectoralis Muscles lcsh:RD78.3-87.3 Postoperative pain Mastectomy Modified Radical Diclofenac Double-Blind Method medicine Humans Prospective Studies Fascia Mastectomy Pain Measurement Clinical Research Article Pain Postoperative business.industry Middle Aged Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure lcsh:Anesthesiology Female Shoulder joint Tramadol business Surgical incision medicine.drug |
| Zdroj: | Korean Journal of Anesthesiology Korean Journal of Anesthesiology, Vol 73, Iss 5, Pp 425-433 (2020) |
| ISSN: | 2005-7563 2005-6419 |
| DOI: | 10.4097/kja.20159 |
| Popis: | Background: Regional nerve blocks are an integral part of multimodal analgesia and should be chosen based on their efficacy, convenience, and minimal side effects. Here, we compare the use of pectoral (PEC II) and serratus-intercostal fascial plane (SIFP) blocks in breast carcinoma cases undergoing modified radical mastectomy (MRM) in terms of the postoperative analgesic efficacy and shoulder mobility.Methods: The primary outcome of this prospective controlled study was to compare the postoperative static and dynamic pain scores, and the secondary outcome was to assess the shoulder pain, range of shoulder joint motion, and hemodynamic parameters. Sixty patients were randomly allocated to three groups and given general anesthesia. All patients received paracetamol, diclofenac, and rescue doses of tramadol based on the Institute's Acute Pain Service (APS) policy. No block was performed in group C (control), whereas groups P and S received PEC II and SIFP blocks, respectively, before surgical incision.Results: The groups were comparable in terms of age, weight, height, and body mass index distribution (P > 0.05). Dynamic pain relief was significantly better 12 and 24 h postoperatively in groups P (P = 0.034 and P = 0.04, respectively) and S (P = 0.01 and P = 0.02, respectively) compared to group C. Shoulder pain relief and shoulder mobility were better in group S, while the hemodynamic parameters were more stable in group P.Conclusions: Both SIFP and PEC blocks have comparable dynamic and static pain relief with better shoulder pain scores in patients receiving SIFP. |
| Databáze: | OpenAIRE |
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