Is the combination of interfascial plane blocks sufficient for awake breast cancer surgery? An observational, prospective, proof-of-concept study

被引:1
|
作者
Ertas, Gamze [1 ]
Cakmak, Hamiyet Senol [1 ]
Ocak, Sonmez [2 ]
Yilmaz, Mert [1 ]
Ozdemir, Dursun Burak [2 ]
Tulgar, Serkan [1 ]
机构
[1] Samsun Univ, Samsun Training & Res Hosp, Dept Anesthesiol & Reanimat, Fac Med, Baris Bulvari Kadikoy Mahallesi 199 PK, TR-55090 Ilkadim, Samsun, Turkiye
[2] Samsun Univ, Samsun Training & Res Hosp, Dept Gen Surg, Fac Med, Samsun, Turkiye
来源
BMC ANESTHESIOLOGY | 2024年 / 24卷 / 01期
关键词
Regional anaesthesia; Breast surgery; Nerve block; Awake surgery; Plane blocks; THORACIC WALL BLOCKS; ERECTOR SPINAE; ANESTHESIA; SERRATUS;
D O I
10.1186/s12871-024-02725-0
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Introduction Breast cancer is the most prevalent cancer among women, often necessitating surgical intervention. While surgeries like lumpectomy can be performed under local anesthesia, more extensive procedures typically require general anesthesia. Awake breast cancer surgery has emerged as an alternative due to risks associated with general anesthesia and patient preference. Methods This prospective observational study, conducted from July 2022 to July 2023, evaluated the effectiveness of ultrasound-guided fascial plane blocks for awake breast surgery. Patients aged 18-80 years undergoing unilateral breast surgery were included, following ethical committee approval and written informed consent. Exclusion criteria were prior breast surgery, coagulopathies, infections, allergies to local anesthetics, psychiatric disorders, body mass index over 40 kg/m(2), and chest deformities. The combination of interpectoral, pecto-serratus, and deep serratus plane blocks was used as the primary anesthetic method, with a superficial parasternal block added in cases where complete cutaneous coverage was not achieved. Results Seventeen patients were enrolled. The primary outcome, sufficient surgical anesthesia without deep sedation, was achieved in 15 patients. The combination of the aforementioned blocks proved effective, with an average surgery duration of 59.66 min, and propofol requirements averaging 1.77 mg/kg/hour. Most patients reported high satisfaction levels, and no early or late block-related complications were observed. Conclusion The combination of fascial plane blocks is a viable option for awake breast cancer surgery, potentially eliminating the need for more invasive anesthesia techniques. Further studies are necessary to confirm these findings in larger, homogeneous patient groups.
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页数:7
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