A prospective study on the comparison of general anesthesia and tea (thoracic epidural anesthesia) for perioperative outcomes in patients undergoing modified radical mastectomy

2021 ◽  
Vol 12 (1) ◽  
pp. 631-635
Author(s):  
Goutham V V N ◽  
Venkata Ganesh M ◽  
Lavanya P V S ◽  
Mrudula Vandana ◽  
Ravikanth S
Keyword(s):  
General Anesthesia ◽  
Respiratory Depression ◽  
Demographic Data ◽  
Radical Mastectomy ◽  
Breast Cancer Surgery ◽  
Perioperative Outcomes ◽  
Epidural Administration ◽  
Thoracic Epidural ◽  
Intraoperative Hypotension ◽  
A Prospective Study

The 2nd most common tumor among women is breast cancer. Surgery is usually done by general anesthesia (GA). TEA is one of the anesthetic procedures that can be performed using local anesthetic epidural administration. TEA may boost pain relief without the potential for respiratory muscle weakness and sedation. An epidural catheter was inserted in T4 to T5 for the T-group, with a 10-15 ml injection of 0.75% ropivacaine. Intermittent supplements of 5-10 ml 0.75% ropivacaine maintained anesthesia. General anesthesia was caused by fentanyl of 1-2 μg/kg, accompanied by propofol (1.5-2 mg/kg), with sevoflurane. We evaluated intraoperative hemodynamics, post-operative patient parameters like nausea and vomiting, shivering, respiratory depression. Overall patient satisfaction is compared between two groups.  The demographic data was similar in both groups. Intraoperative hypotension observed in 33.3% of group T patients and 16.6% of group G patients. 20% of the group T patients showed intraoperative bradycardia, whereas 6.66% of group G patients showed intraoperative bradycardia. Incidence of vomiting & nausea is 26.6% in group G, whereas in group T it is 6.66%. The incidence of post-operative shivering is equal in both groups. Post-operative respiratory depression is not observed in both groups. 86.6% of the group T patients are satisfied overall, whereas it is 60% in group G.

scholarly journals A prospective study of factors affecting seroma formation after modified radical mastectomy in patients of carcinoma of breast

2020 ◽  
Vol 7 (9) ◽  
pp. 2919
Author(s):  
Anuradha Chaudhary ◽  
Sonveer Gautam
Keyword(s):  
Radical Mastectomy ◽  
Seroma Formation ◽  
Breast Cancer Surgery ◽  
Individual Risk ◽  
Factors Affecting ◽  
Medical College ◽  
Predictive Variables ◽  
Flap Fixation ◽  
Gandhi Medical College ◽  
A Prospective Study

Background: Seroma, a clinically evident subcutaneous collection of serous fluid after breast cancer surgery, developing in approximately 30% of cases. To prevent seroma formation, it is important to estimate individual risk of seroma formation, i.e., the identification of predictive variables will be helpful in designing future trials aimed at reducing the incidence of this seroma. This study intends to find out the association between certain pre-operative, intra-operative, and post-operative factors related to MRM and incidence of seroma formation.Methods: It was an observational prospective on 100 females undergoing MRM at Department of Gandhi Medical College Bhopal, Madhya Pradesh, India. Patients were observed postoperatively for seroma formation and factors affecting it.Results: patients with seroma formation in this study tended to be older age (age, 62.60±10.40 years versus 56.13±10.31 years; p<0.001) and more obese (BMI, 26.95±4.2 versus 24.61±3.61; p<0.001). Higher amount of initial drain volume was directly related to seroma formation.  Initiation of arm physiotherapy after surgery (3.14±0.23 days versus 2.17±0.74 days; p=0.043).Conclusions: The incidence of seroma is higher in older and in more obese patients. The incidence is decreased by flap fixation under muscles and early physiotherapy. Furthermore, few interventions in the operative period can help minimize the chances of seroma formation.

Comparative Study of Thoracic Epidural and General Anesthesia in Modified Radical Mastectomy

2018 ◽  
Vol 5 (10) ◽  
pp. 1593-1596
Author(s):  
Srinivas Rapolu ◽  
◽  
A. Srikanth Reddy ◽  
Syed Ali Asim ◽  
◽  
...  
Keyword(s):  
Comparative Study ◽  
General Anesthesia ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Thoracic Epidural

scholarly journals Incidence of Intraoperative Hypotension as a Function of the Chosen Definition

2007 ◽  
Vol 107 (2) ◽  
pp. 213-220 ◽  
Author(s):  
Jilles B. Bijker ◽  
Wilton A. van Klei ◽  
Teus H. Kappen ◽  
Leo van Wolfswinkel ◽  
Karel G. M. Moons ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Adverse Outcomes ◽  
Perioperative Outcomes ◽  
Common Side Effect ◽  
Threshold Values ◽  
Intraoperative Hypotension ◽  
Cumulative Incidence Curve ◽  
Definition Of

Background Intraoperative hypotension (IOH) is a common side effect of general anesthesia and has been reported to be associated with adverse perioperative outcomes. These associations were found using different definitions for IOH. It is unknown whether the incidences of IOH found with those different definitions are comparable. The authors aimed to describe the relation between the chosen definition and incidence of IOH. Methods First, a systematic literature search was performed to identify recent definitions of IOH that have been used in the anesthesia literature. Subsequently, these definitions were applied to a cohort of 15,509 consecutive adult patients undergoing noncardiac surgery during general anesthesia. The incidence of IOH according to the different threshold values was calculated, and the effect of a defined minimal duration of a hypotensive episode was studied. Results Many different definitions of IOH were found. When applied to a cohort of patients, these different definitions resulted in different IOH incidences. Any episode of systolic blood pressure below 80 mmHg was found in 41% of the patients, whereas 93% of the patients had at least one episode of systolic blood pressure more than 20% below baseline. Both definitions are frequently used in the literature. The relation between threshold values from the literature and IOH incidence shows an S-shaped cumulative incidence curve, with occurrence frequencies of IOH varying from 5% to 99%. Conclusions There is no widely accepted definition of IOH. With varying definitions, many different incidences can be reproduced. This might have implications for previously described associations between IOH and adverse outcomes.

scholarly journals A Comparative Study between Thoracic Epidural Anesthesia and General Anesthesia for Patients Who Underwent Modified Radical Mastectomy with Axillary Lymph Node Dissection in De La Salle University Medical Center

2015 ◽  
Vol 7 (2) ◽  
pp. 111
Author(s):  
Eva Oktavia
Keyword(s):  
Lymph Node ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Axillary Lymph Node ◽  
Radical Mastectomy ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Modified Radical Mastectomy ◽  
Thoracic Epidural

BACKGROUND: To compare the recovery time and other related clinical outcomes among patients who underwent Modified Radical Mastectomy (MRM) with axillary lymph node dissection under Continuous Thoracic Epidural Anesthesia (CTEA) and General Endotracheal Tube Anesthesia (GETA).METHODS: A retrospective cross-sectional study with 70 patients who underwent MRM in De La Salle University Medical Centre (DLSUMC), categorized into GETA and CTEA group consisted of 35 patients each. Per oral premedications 15 mg midazolam, 40 mg omeprazole and 10 mg metoclopramide were given 1 hour prior to surgery. Intra-operative hypotension/hypertension, tachycardia/bradycardia status, length of Post-Anesthesia Care Unit (PACU) and hospital stay, and Post Operative Nausa and Vomiting (PONV) incidence were compared between 2 groups.RESULTS: Preoperatively, there were no significant differences between the groups in terms of subject characteristic. Intra-operatively, hypertension was more frequent in GETA group (28.6% vs. 0%), while hypotension was more frequent in the CTEA (80% vs. 57.1%). Tachycardia was more frequent in GETA group (46.6% vs. 0%), meanwhile bradycardia was more frequent in CTEA (40% vs. 17.1%). Postoperatively, the GETA group had shorter PACU stay than CTEA (230 mins vs. 267 mins), but CTEA group had a shorter time of hospital stay compared to GETA (58.1 hours vs. 67.7 hours). The incidence of PONV were comparable among the two groups (GETA 46.7% vs. CTEA 50%). Statistically there were no significant differences between the two groups in all of the above characteristics.CONCLUSION: CTEA technique has no effect on inducing hypertension and tachycardia, but hypotension and bradycardia may occur. Although GETA gives shorter PACU duration, CTEA gives shorter hospital stay. This gave impression that CTEA is an effective alternative technique to GETA in patients who underwent MRM with axillary dissection.KEYWORDS: modified radical mastectomy, general anesthesia, epidural anesthesia

scholarly journals Pectoral nerves block as a component of multimodal analgesia in breast cancer surgery

2020 ◽  
Vol 16 (6) ◽  
pp. 30-36
Author(s):  
A. S. Buyanov ◽  
V. V. Stadler ◽  
D. V. Zabolotskiy ◽  
V. A. Koryachkin ◽  
M. O. Vozdvizhenskiy ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Radical Mastectomy ◽  
Opioid Analgesics ◽  
Multimodal Analgesia ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
Axillary Lymph ◽  
General Anesthesia Group ◽  
Pectoral Nerve ◽  
Group 1

Objective: to evaluate the efficacy and safety of adding pectoral nerve block to anesthesia regimen in radical mastectomy.Subjects and methods. 65 female patients underwent unilateral radical mastectomy under general anesthesia. All patients enrolled into the study were divided into two groups. Group 1 included patients (the main one, n = 33) who had PEC block and general anesthesia; Group 2 (the control one, n = 32) had general anesthesia only.Results. The group of patients with PEC block versus the Control Group, demonstrated a lower score of the visual analogue scale at all stages of the study. The intra-operative fentanyl consumption was statistically significantly lower in Group 1 versus the Control Group (290.91 ± 67.84 and 393.75 ± 66.90 μg, respectively, p < 0.033). The consumption of opioid analgesics during the 1st day in the Main Group was 2-fold lower compared to the Control Group – 30.91 ± 12.34 and 63.75 ± 9.42 mg, respectively (p < 0.026). In Group 1, the time till the first analgesia with promedol made 309.55 ± 56.59 minutes.Conclusions. Pectoral nerves block combined with general anesthesia provides effective analgesia during breast surgery with axillary lymph node dissection.

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