Benefits in radical mastectomy protocol: a randomized trial evaluating the use of regional anesthesia

被引：41
作者：
Matsumoto, Marcio [1 ,2 ]
Flores, Eva M. [1 ,2 ]
Kimachi, Pedro P. [1 ,2 ]
Gouveia, Flavia V. [1 ]
Kuroki, Mayra A. [1 ]
Barros, Alfredo C. S. D. [1 ]
Sampaio, Marcelo M. C. [1 ]
Andrade, Felipe E. M. [1 ]
Valverde, Joao [1 ,2 ]
Abrantes, Eduardo F. [1 ]
Simoes, Claudia M. [1 ,2 ]
Pagano, Rosana L. [1 ]
Martinez, Raquel C. R. [1 ]
机构：
[1] Hosp Sirio Libanes, Rua Prof Daher Cutait 69, BR-01308060 Sao Paulo, Brazil
[2] Sao Paulo Serv Med Anestesia, Rua Adma Jafet,91 Bela Vista, BR-01308050 Sao Paulo, SP, Brazil
来源：
SCIENTIFIC REPORTS | 2018年 / 8卷
基金：
巴西圣保罗研究基金会;
关键词：
BREAST-CANCER SURGERY; SERRATUS PLANE BLOCK; PECTORAL NERVE BLOCK; PECS I BLOCK; PERSISTENT PAIN; PROINFLAMMATORY CYTOKINES; POSTOPERATIVE ANALGESIA; LOCAL-ANESTHETICS; ASSOCIATION; MANAGEMENT;
D O I：
10.1038/s41598-018-26273-z
中图分类号：
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号：
07 ; 0710 ; 09 ;
摘要：
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10. This is a prospective, randomized controlled trial. Fifty patients were randomized to general anesthesia only or general anesthesia associated with SAM block + PECS I (25 per group). The association of SAM block + PECS I with general anesthesia reduced intraoperative fentanyl consumption, morphine use and visual analog pain scale scores in the post-anesthetic care unit (PACU) and at 24 h after surgery. In addition, the anesthetic protocol decreased side effects and sedation 24 h after surgery compared to patients who underwent general anesthesia only. IL-6 levels increased after the surgery compared to baseline levels in both groups, and no differences in IL-10 and IL-1 beta levels were observed. Our protocol improved the outcomes of mastectomy, which highlight the importance of improving mastectomy protocols and focusing on the benefits of regional anesthesia.
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页数：9
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