The paravertebral lamina technique: a new regional anesthesia approach for breast surgery
| Autor: | Oliver Danzeisen, Henning Hermanns, Robert Werdehausen, Enrico Monaca, Tobias Jüttner, Michael Winterhalter, Benedikt H. J. Pannen, Wolfgang Janni |
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| Přispěvatelé: | Anesthesiology, ACS - Heart failure & arrhythmias, APH - Quality of Care, ANS - Neuroinfection & -inflammation, ACS - Diabetes & metabolism, AII - Inflammatory diseases |
| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty Lamina Visual analogue scale medicine.medical_treatment Breast surgery Breast Neoplasms Pilot Projects Anesthesia General Anesthesia Spinal Catheterization Postoperative care Postoperative Complications Intraoperative care medicine Humans Intubation Anesthesia Breast Injections Spinal Mastectomy Aged Aged 80 and over Pain Postoperative regional business.industry Middle Aged Spine paravertebral nerve block Surgery Analgesics Opioid Catheter Anesthesiology and Pain Medicine Regional anesthesia Anesthesia Recovery Period Anesthetic techniques: nerve block paravertebral nerve block Female Anesthesia regional business Anesthetic techniques: nerve block Perioperative care |
| Zdroj: | Journal of clinical anesthesia, 23(6), 443-450. Elsevier Inc. |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/j.jclinane.2010.12.015 |
| Popis: | Study Objective To test the feasibility and efficacy of a new approach to paravertebral catheter placement in patients undergoing major surgery of the breast. Design Single-group, single-center observational study. Setting Operating room, postoperative recovery area, and normal ward of a university hospital. Patients 25 ASA physical status 1, 2, 3, and 4 patients undergoing major unilateral surgery of the breast. Interventions Paravertebral catheters for intraoperative and postoperative anesthesia and analgesia were applied using the recently described lamina technique. This technique is performed at a more medial puncture site, avoiding the pleura. Measurements Additional opioid requirements were recorded to assess effectiveness of regional anesthesia. At the time of catheter withdrawal, patients, staff nurses, and anesthesiologists who provided postoperative pain management were asked to rate their satisfaction with paravertebral catheter effectiveness. Main Results All patients successfully received a paravertebral catheter using the lamina technique. During the surgical procedure, 84% of patients received no additional opioids after intubation. No patient required opioids as rescue medication postoperatively (visual analog scale rating > 30mm) or during the rest of the hospital stay. Postoperative analgesia provided with paravertebral catheters was rated very high by patients, staff nurses, and anesthesiologists involved in postoperative care. Conclusions The lamina technique for placement of a paravertebral catheter is a feasible and effective technique for intraoperative and postoperative analgesia in patients scheduled for major breast surgery with or without axillary lymph node resection. |
| Databáze: | OpenAIRE |
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