Buscar en
Revista Española de Anestesiología y Reanimación (English Edition)
Toda la web
Inicio Revista Española de Anestesiología y Reanimación (English Edition) The usefulness of interpectoral block as an analgesic technique in breast cancer...
Journal Information
Vol. 65. Issue 4.
Pages 188-195 (April 2018)
Share
Share
Download PDF
More article options
ePub
Visits
3
Vol. 65. Issue 4.
Pages 188-195 (April 2018)
Original article
DOI: 10.1016/j.redare.2017.11.017
The usefulness of interpectoral block as an analgesic technique in breast cancer surgery
Utilidad del bloqueo interpectoral continuo como técnica analgésica en cirugía oncológica de mama
Visits
...
R. Ortiz de la Tabla González
Corresponding author
raquelortizdelat@gmail.com

Corresponding author.
, P. Gómez Reja, D. Moreno Rey, C. Pérez Naranjo, I. Sánchez Martín, M. Echevarría Moreno
UGCBQ Área Sur de Sevilla, Sevilla, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (5)
Show moreShow less
Tables (6)
Table 1. Patient characteristics by group.
Table 2. Type of surgery, by group.
Table 3. Continuous interpectoral block technique (CPEC group).
Table 4. Need for rescue analgesia in both groups at all data collection time points.
Table 5. Side effects in both groups at all data collection time points.
Table 6. Degree of patient satisfaction in both groups.
Show moreShow less
Additional material (1)
Abstract
Objective

To compare the analgesic efficacy of continuous interpectoral block (CIPB) compared to intravenous analgesia (IV) after breast surgery.

Material and method

A prospective, comparative and randomised study of women aged from 18 to 75years, ASAI-III, operated for breast cancer. In group1 (CIPB) after general anaesthetic, an ultrasound-guided interpectoral catheter was placed and 30ml of 0.5% ropivacaine was administered through it. In the event of an increase in heart rate and blood pressure >15% after the surgical incision, intravenous fentanyl 1μgkg−1 was administered, repeating the dose as necessary. In the postoperative period, perfusion of ropivacaine 0.2% 5mlh−1; with PCA bolus 5ml/30min was administered through the catheter for 24h and rescue analgesia prescribed with 5mg subcutaneous morphine chloride. In group2 (IV), after induction of general anaesthesia, intravenous fentanyl was administered in the same way as in the other group. The patients received metamizole 2g with dexketoprofen 50mg and ondansetron 4mg postoperatively followed by perfusion of metamizole 4%, tramadol 0.2% and ondansetron 0.08% 2mlh−1; with PCA bolus 2ml/20min for 24h. The same rescue analgesia was prescribed. The principal variables recorded were pain at rest and during movement, according to a simple verbal scale (VAS 0–10) and the rescue analgesia required on discharge from recovery, at 12 and at 24h.

Results

137 patients were included: 81 in group1 (59.12%) and 56 in group2 (40.87%). No significant differences were observed in the analgesia between either group, but differences were observed in the dose of intraoperative fentanyl (p<.05). Differences that were not significant were observed in the rescue analgesia required on recovery (10% fewer on group1).

Conclusions

Both techniques provided effective postoperative analgesia, but the CIPB group required significantly less intraoperative fentanyl.

Keywords:
Ultrasound
Pectoral nerves
Regional anaesthesia
Breast surgery
Resumen
Objetivo

Comparar la eficacia analgésica del bloqueo interpectoral continuo (BIPC) frente a la analgesia intravenosa (i.v.) tras cirugía de mama.

Material y método

Estudio prospectivo, comparativo y aleatorizado sobre mujeres de 18-75años, ASAI-III, intervenidas de cirugía oncológica de mama. En el grupo1 (BIPC), tras la inducción de anestesia general se colocó un catéter interpectoral ecoguiado y se administró ropivacaína 0,5% 30ml a su través. Tras la incisión quirúrgica, si la frecuencia cardiaca y la presión arterial se incrementaron >15% se administró fentanilo i.v., 1μg·kg−1, repitiendo la dosis en caso necesario. En el postoperatorio se inició perfusión de ropivacaína 0,2% 5ml·h−1; con bolo PCA 5ml/30min por el catéter durante 24h, y se prescribió analgesia de rescate con cloruro mórfico 5mg subcutáneo. En el grupo2 (i.v.), tras la inducción de anestesia general se administró fentanilo i.v. en caso necesario de la misma forma que en el otro grupo. En el postoperatorio se administró metamizol 2g con dexketoprofeno 50mg y ondansetrón 4mg seguido de perfusión de metamizol 4%, tramadol 0,2% y ondansetrón 0,08% 2ml·h−1; con bolo PCA 2ml/20min durante 24h. Se prescribió el mismo rescate analgésico. Las variables principales registradas fueron dolor en reposo y durante el movimiento, según una escala verbal simple (EVA 0-1), y la analgesia de rescate precisada al alta de reanimación, a las 12 y a las 24h.

Resultados

Se incluyeron 137 pacientes: 81 en el grupo1 (59,12%) y 56 en el grupo2 (40,87%). No se observaron diferencias significativas en analgesia entre grupos, pero sí en la dosis de fentanilo intraoperatorio (p<0,05). Se observaron diferencias no significativas en la analgesia de rescate requerida en reanimación (10% menor en el grupo1).

Conclusiones

Ambas técnicas proporcionaron analgesia postoperatoria eficaz, pero el grupo BIPC precisó significativamente menos fentanilo intraoperatorio.

Palabras clave:
Ultrasonidos
Nervios pectorales
Anestesia regional
Cirugía de mama

Article

These are the options to access the full texts of the publication Revista Española de Anestesiología y Reanimación (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Anestesiología y Reanimación (English Edition)

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 22,50 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
Supplemental materials
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.