Anesthesia For Radical Mastectomy Research Articles

Multi-injection paravertebral block with low volume local anesthetic for anesthesia in radical mastectomy - randomized controlled trial.

Paravertebral block (PVB) is generally used in breast cancer surgery in combination with general anesthesia. Only multi-injection PVB can decrease the volume of local anesthetic (LA) while maintaining the efficacy of the block. The use of small LA volumes in PVB prevents its undesirable distribution from the injection site. The objective of this study was to examine the effect of multi-injection paravertebral block for anesthesia in radical mastectomy in breast cancer patients. The study analyzed 130 cases of anesthesia in radical mastectomy. The patients were randomized to two groups: Group 1 (n = 65) received general anesthesia (GA), and Group 2 (n = 65) received PVB (Th1 to Th6) with GA. In Group 2, 0.75% ropivacaine solution at 1.5 to 3.0 mL per level was used. Serum cortisol levels were measured. The post-operative acute pain perception was measured using a 100-point visual analogue scale (VAS). Fentanyl consumption in Group 1 was 70% higher than in Group 2 (P < 0.05). No increase in intra-operative cortisol levels was seen; 2 hours after surgery, cortisol levels were 3.3 times and 2.7 times higher than the baseline in Group 1 and Group 2, respectively (P < 0.05). VAS scores in Group 2 were lower at 2, 6, 12, and 48 hours after surgery (P < 0.05). Supplementation of GA with multilevel PVB decreased the intra-operative fentanyl consumption. In radical mastectomy, the intra-operative cortisol levels do not increase. The highest VAS pain scores are seen within the first 24 hours after mastectomy.

Features of the development of thoracic paravertebral blockade as a component of anesthesia in radical mastectomy

The aim of this work is the study of thoracic paravertebral blockade (PVB) in different anatomical parts of the chest. The usage of the PVB for 31 women was analysed. PVB was performed at the levels of Th1, Th2, Th3, Th4, Th5 and Th6, under ultrasound guidance. 1.5 ml of local anesthetic (0,75% solution of ropivacaine) was introduced on each level. The borders of altered pain sensitivity was evaluated using "pin prick" at the notional vertical lines of the chest (paravertebral, scapular, posterior axillary, mid-axillary, midclavicular and sternal). The obtained distances were measured by centimeter ruler. After blockade of spinal nerves from Th1 through Th6, the extent of the blockade of the pain sensitivity was reveded: paravertebral line at 21.7±3.9 cm, along the scapular line is a distance of 19.1±3.6 cm, on posterior axillary line of 14.5±2.6 cm, on an mid-axillary line - of 14.9±3.3 cm on the midclavicular line is 11.9±4.2 cm, sternal line - 5.4±3,3 cm. The decrease in the severity of the blockade on pain sensitivity in the midclavicular line from central to peripheral anatomical areas was observed. 71% of patients on the first day after surgery was not required additional analgesia, in 16% of cases the period of analgesia ranged from 6 to 18 hours. The decrease of the size of analgesia takeplace surface when moving from the spine to the sternum that can significantly affect the quality of anesthesia during operations on the thorax. PVB intercostal nerve Th1-Th6 with small doses of local anesthetic anesthetic is effective in ensuring operations in the amount of radical mastectomy.

The Use of Hypertensive Anesthesia in Radical Mastectomy*

The Use of Hypertensive Anesthesia in Radical Mastectomy*

Anesthesia for Radical Mastectomy with Intravenous Pentothal Sodium and Intercostal Nerve Block

THE increasing use of Pentothal Sodium as an important anesthetic agent during major surgical procedures is well attested in the current literature on methods of anesthesia. That its optimal usefulness with the greatest measure of safety is achieved when it is employed in conjunction with supplemental anesthetic agents is borne out by reports relating to such conjoint use or by those that discuss in passing the supplemental use of other agents. My1 previous report discussed the combined use of intravenous Pentothal Sodium and local nerve block (splanchnic) in upper abdominal surgery. In this earlier study, in which a new splanchnic . . .

Anesthesia for Radical Mastectomy with Intravenous Pentothal Sodium and Intercostal Nerve Block

THE increasing use of Pentothal Sodium as an important anesthetic agent during major surgical procedures is well attested in the current literature on methods of anesthesia. That its optimal usefulness with the greatest measure of safety is achieved when it is employed in conjunction with supplemental anesthetic agents is borne out by reports relating to such conjoint use or by those that discuss in passing the supplemental use of other agents. My1 previous report discussed the combined use of intravenous Pentothal Sodium and local nerve block (splanchnic) in upper abdominal surgery. In this earlier study, in which a new splanchnic . . .