The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial
Background: Increasing number of patients are being operated because of breast cancer. Seroma is the most common problem that occurs after surgery that increases morbidity. For postoperative pain management, Thoracic Paravertebral Block (TPVB) has long been considered the gold standard technique. Wi...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Brazilian Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001420300476 |
| _version_ | 1811180657180672000 |
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| author | Alparslan Kuş Ufuk H. Yörükoğlu Can Aksu Saffet Çınar Nuh Zafer Cantürk Yavuz Gürkan |
| author_facet | Alparslan Kuş Ufuk H. Yörükoğlu Can Aksu Saffet Çınar Nuh Zafer Cantürk Yavuz Gürkan |
| author_sort | Alparslan Kuş |
| collection | DOAJ |
| description | Background: Increasing number of patients are being operated because of breast cancer. Seroma is the most common problem that occurs after surgery that increases morbidity. For postoperative pain management, Thoracic Paravertebral Block (TPVB) has long been considered the gold standard technique. With performing TPVB, sympathetic nerves are also blocked. Objective: With this study, we aimed to search the effect of TPVB on seroma reduction in patients who undergo mastectomy and axillary node dissection surgery. Methods: Forty ASA I–II female patients aged 18–65, who were scheduled to go under elective unilateral mastectomy and axillary lymph node resection were included to the study. Patients were randomized into two groups as TPVB and Control group. Ultrasound guided TPVB with 20 mL 0.25% bupivacaine was performed at T1 level preoperatively to the TPVB group patients. All patients were provided with i.v. patient-controlled analgesia device. Seroma formation amounts, morphine consumptions and Numeric Rating Scale (NRS) scores for pain were recorded 24th hour postoperatively. Results and conclusions: Mean seroma formation at postoperative 24th hour was 112.5 ± 53.3 mL in the control group and 74.5 ± 47.4 mL in the TPVB group (p = 0.022). NRS scores were similar between two groups (p = 0.367) at postoperative 24th hour but mean morphine consumption at postoperative 24th hour was 5.6 ± 4 mg in the TPBV group, and 16.6 ± 6.9 mg in the control group (p < 0.001). TPVB reduces the amount of seroma formation while providing effective analgesia in patients who undergo mastectomy and axillary lymph node removal surgery. Resumo: Introdução: Observa-se aumento do número de pacientes submetidos à cirurgia por neoplasia mamária. Seroma é a mais frequente complicação pós-operatória que aumenta a morbidade. Há muito tempo, considera-se o Bloqueio Paravertebral Torácico (BPVT) a técnica padrão ouro para o controle da dor pós-operatória. O BPVT provoca, igualmente, o bloqueio da inervação simpática. Objetivo: Identificar o efeito do BPVT na redução de seroma em pacientes que realizaram mastectomia e dissecção dos linfonodos axilares. Método: Foram incluídas no estudo 40 pacientes do sexo feminino ASA I–II, entre 18 e 65 anos de idade, submetidas a mastectomia eletiva unilateral com ressecção de linfonodos axilares. As pacientes foram randomizadas em grupo BPVT e grupo controle. As pacientes do grupo BPVT foram submetidas ao BPVT guiado por ultrassom no nível de T1 e 20 mL de bupivacaína 0,25% foram administrados antes da cirurgia. Bomba de infusão IV ACP foi prescrita para todas as pacientes. Na 24a hora pós-operatória foram registradas a quantidade de produção de seroma, o consumo de morfina e a avaliação da dor pela escala de avaliação numérica (NRS – do inglês Numeric Rating Scale). Resultados: A quantidade média de seroma na 24a hora pós-operatória foi 112,5 ± 53,3 mL no grupo controle e 74,5 ± 47,4 mL no grupo BPVT (p = 0,022). Na 24a hora pós-operatória a pontuação NRS foi semelhante nos dois grupos (p = 0,367), porém o consumo médio de morfina foi 5,6 ± 4 mg no grupo BPVT e 16,6 ± 6,9 mg no grupo controle (p < 0,001). Conclusões: O BPVT reduz a quantidade de seroma enquanto proporciona analgesia efetiva em pacientes que se submetem a mastectomia e remoção dos linfonodos axilares. |
| first_indexed | 2024-04-11T09:06:49Z |
| format | Article |
| id | doaj.art-1c8dc14804a84784abd4fbcec0440b5e |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-11T09:06:49Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-1c8dc14804a84784abd4fbcec0440b5e2022-12-22T04:32:36ZengElsevierBrazilian Journal of Anesthesiology0104-00142020-05-01703215219The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trialAlparslan Kuş0Ufuk H. Yörükoğlu1Can Aksu2Saffet Çınar3Nuh Zafer Cantürk4Yavuz Gürkan5Kocaeli University Hospital, Department of Anesthesiology and Reanimation, Kocaeli, TurkeyKocaeli University Hospital, Department of Anesthesiology and Reanimation, Kocaeli, Turkey; Corresponding author.Kocaeli University Hospital, Department of Anesthesiology and Reanimation, Kocaeli, TurkeyKocaeli University Hospital, Department of General Surgery, Kocaeli, TurkeyKocaeli University Hospital, Department of General Surgery, Kocaeli, TurkeyKocaeli University Hospital, Department of Anesthesiology and Reanimation, Kocaeli, TurkeyBackground: Increasing number of patients are being operated because of breast cancer. Seroma is the most common problem that occurs after surgery that increases morbidity. For postoperative pain management, Thoracic Paravertebral Block (TPVB) has long been considered the gold standard technique. With performing TPVB, sympathetic nerves are also blocked. Objective: With this study, we aimed to search the effect of TPVB on seroma reduction in patients who undergo mastectomy and axillary node dissection surgery. Methods: Forty ASA I–II female patients aged 18–65, who were scheduled to go under elective unilateral mastectomy and axillary lymph node resection were included to the study. Patients were randomized into two groups as TPVB and Control group. Ultrasound guided TPVB with 20 mL 0.25% bupivacaine was performed at T1 level preoperatively to the TPVB group patients. All patients were provided with i.v. patient-controlled analgesia device. Seroma formation amounts, morphine consumptions and Numeric Rating Scale (NRS) scores for pain were recorded 24th hour postoperatively. Results and conclusions: Mean seroma formation at postoperative 24th hour was 112.5 ± 53.3 mL in the control group and 74.5 ± 47.4 mL in the TPVB group (p = 0.022). NRS scores were similar between two groups (p = 0.367) at postoperative 24th hour but mean morphine consumption at postoperative 24th hour was 5.6 ± 4 mg in the TPBV group, and 16.6 ± 6.9 mg in the control group (p < 0.001). TPVB reduces the amount of seroma formation while providing effective analgesia in patients who undergo mastectomy and axillary lymph node removal surgery. Resumo: Introdução: Observa-se aumento do número de pacientes submetidos à cirurgia por neoplasia mamária. Seroma é a mais frequente complicação pós-operatória que aumenta a morbidade. Há muito tempo, considera-se o Bloqueio Paravertebral Torácico (BPVT) a técnica padrão ouro para o controle da dor pós-operatória. O BPVT provoca, igualmente, o bloqueio da inervação simpática. Objetivo: Identificar o efeito do BPVT na redução de seroma em pacientes que realizaram mastectomia e dissecção dos linfonodos axilares. Método: Foram incluídas no estudo 40 pacientes do sexo feminino ASA I–II, entre 18 e 65 anos de idade, submetidas a mastectomia eletiva unilateral com ressecção de linfonodos axilares. As pacientes foram randomizadas em grupo BPVT e grupo controle. As pacientes do grupo BPVT foram submetidas ao BPVT guiado por ultrassom no nível de T1 e 20 mL de bupivacaína 0,25% foram administrados antes da cirurgia. Bomba de infusão IV ACP foi prescrita para todas as pacientes. Na 24a hora pós-operatória foram registradas a quantidade de produção de seroma, o consumo de morfina e a avaliação da dor pela escala de avaliação numérica (NRS – do inglês Numeric Rating Scale). Resultados: A quantidade média de seroma na 24a hora pós-operatória foi 112,5 ± 53,3 mL no grupo controle e 74,5 ± 47,4 mL no grupo BPVT (p = 0,022). Na 24a hora pós-operatória a pontuação NRS foi semelhante nos dois grupos (p = 0,367), porém o consumo médio de morfina foi 5,6 ± 4 mg no grupo BPVT e 16,6 ± 6,9 mg no grupo controle (p < 0,001). Conclusões: O BPVT reduz a quantidade de seroma enquanto proporciona analgesia efetiva em pacientes que se submetem a mastectomia e remoção dos linfonodos axilares.http://www.sciencedirect.com/science/article/pii/S0104001420300476Bloqueio paravertebralDor pós-operatóriaRedução de seromaCâncer de mama |
| spellingShingle | Alparslan Kuş Ufuk H. Yörükoğlu Can Aksu Saffet Çınar Nuh Zafer Cantürk Yavuz Gürkan The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial Brazilian Journal of Anesthesiology Bloqueio paravertebral Dor pós-operatória Redução de seroma Câncer de mama |
| title | The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial |
| title_full | The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial |
| title_fullStr | The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial |
| title_full_unstemmed | The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial |
| title_short | The effect of thoracic paravertebral block on seroma reduction in breast surgery – a randomized controlled trial |
| title_sort | effect of thoracic paravertebral block on seroma reduction in breast surgery a randomized controlled trial |
| topic | Bloqueio paravertebral Dor pós-operatória Redução de seroma Câncer de mama |
| url | http://www.sciencedirect.com/science/article/pii/S0104001420300476 |
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