scholarly journals IMPACT OF PECTORAL NERVE BLOCK AND THORACIC PARAVERTEBRAL BLOCK ON OCCURRENCE OF THE CHRONIC POSTOPERATIVE PAIN AFTER BREAST CANCER SURGERY

2021 ◽  
Vol 2 (1) ◽  
pp. 109
Author(s):  
V. V. Martsiniv ◽  
O. A. Loskutov
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Nerve Block ◽  
Cancer Surgery ◽  
Paravertebral Block ◽  
Breast Cancer Surgery ◽  
Chronic Postoperative Pain ◽  
Thoracic Paravertebral Block ◽  
Pectoral Nerve

scholarly journals EFFICACY OF PECTORAL NERVE BLOCK TYPE II VERSUS THORACIC PARAVERTEBRAL BLOCK FOR ANALGESIA IN BREAST CANCER SURGERY

2020 ◽  
Vol 73 (7) ◽  
pp. 1470-1475
Author(s):  
Volodymyr V. Martsiniv ◽  
Oleg A. Loskutov ◽  
Andriy M. Strokan ◽  
Mihaylo V. Bondar
Keyword(s):  
Breast Cancer ◽  
Nerve Block ◽  
Cancer Surgery ◽  
Paravertebral Block ◽  
Breast Cancer Surgery ◽  
Block Type ◽  
Type Ii ◽  
Thoracic Paravertebral Block ◽  
Pectoral Nerve ◽  
Block Groups

The aim: to compare the efficacy of pectoral nerve block type II and thoracic paravertebral block for analgesia during and after breast cancer surgery. Materials and methods: Sixty adult women were undergoing unilateral radical mastectomy or quadrantectomy with axillary dissection. Patients were randomized to receive either pectoral nerve block with ropivacaine 0.375% 30 ml or thoracic paravertebral block with ropivacaine 0.5% 20 ml. Evaluated variables included pain intensity at 0, 2, 4, 6, 12, 18 and 24 hours, intraoperative fentanyl, 24-hour postoperative opioid (promedol) and nonopioid (ketoprofen) consumption, the time to first rescue analgesia. Results: There were no statistically significant differences between pectoral block and paravertebral block groups in intraoperative fentanyl consumption 2,2 (1,81-2,81) vs 1,9 (1,63-2,25) mcg/kg/hour (Р>0,05) and in the pain intensity during the first 24 hours after operation. The mean postoperative 24-hour promedol and ketoprofen consumption was 4,0 (±8,14) mg vs 5,0 (±8,85) mg (Р>0,05) and 66,7 (±66,09) mg vs 95,8 (±90,78) mg (Р>0,05) in the pectoral and paravertebral block groups respectively. Time to the first analgesia request was longer in pectoral block group — 540 (455,0-600,0) min vs 515 (265,0-650,0) min (Р>0,05). There were no complications after pectoral blocks and 2 complications after paravertebral blocks. Conclusions: in breast cancer surgery pectoral nerve block type II can provide postoperative analgesia comparable to thoracic paravertebral block with lower complications rate.

scholarly journals Efficacy of pectoral nerve block type II versus thoracic paravertebral block for analgesia in breast cancer surgery

2020 ◽  
Vol 33 (4) ◽  
pp. 296-301
Author(s):  
Volodymyr Martsiniv ◽  
Oleg Loskutov ◽  
Andriy Strokan ◽  
Maksim Pylypenko ◽  
Mihailo Bondar
Keyword(s):  
Breast Cancer ◽  
Nerve Block ◽  
Cancer Surgery ◽  
Paravertebral Block ◽  
Breast Cancer Surgery ◽  
Block Type ◽  
Type Ii ◽  
Thoracic Paravertebral Block ◽  
Pectoral Nerve

Impact of pectoral nerve block on postoperative pain and quality of recovery in patients undergoing breast cancer surgery

2018 ◽  
Vol 35 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Yoshinori Kamiya ◽  
Miki Hasegawa ◽  
Takayuki Yoshida ◽  
Misako Takamatsu ◽  
Yu Koyama
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Nerve Block ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Quality Of Recovery ◽  
Pectoral Nerve

scholarly journals Efficacy of the pectoral nerve block type II and paravertebral block for enhanced recovery after breast cancer surgery

2021 ◽  
Vol 17 (4) ◽  
pp. 43-50
Author(s):  
V.V. Martsiniv
Keyword(s):  
Breast Cancer ◽  
Nerve Block ◽  
Enhanced Recovery ◽  
Cancer Surgery ◽  
Paravertebral Block ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
Block Type ◽  
Type Ii ◽  
Pectoral Nerve

Background. Breast cancer surgery is associated with severe postoperative pain and increased frequency of postope­rative nausea and vomiting (PONV). It slows down patients’ mobilization in the postoperative period. Regional anesthesia provides better analgesia and can be part of enhanced recovery after surgery. The purpose of this study is to compare the efficacy of the pectoral nerve block type II, paravertebral block, and systemic analgesia concerning the opioids consumption, PONV, time to first food intake, and mobilization of patients in the perioperative period of breast cancer surgery. Materials and methods. Ninety-one adult women after unilateral radical mastectomy or quadrantectomy with axillary dissection were enrolled and randomized into three groups depending on the type of anesthesia. The control group included only patients with general ane­sthesia (GA), pectoral block group — GA plus pectoral nerve block type II with ropivacaine 0.375% 30 ml, and paravertebral block (PVB) group — GA plus thoracic paravertebral block with ropivacaine 0.5% 20 ml. The evaluated variables included ­opioids consumption during and after surgery, the occurrence of PONV, the time to the first feeding, and first mobilization in the postoperative period. Results. The dose of fentanyl during the operation was 2.6 (2.07‑3.62) μg/kg/h in the control group, 2.3 (1.86‑2.94) μg/kg/h in the PB group, 1.9 (1.62‑2.24) μg/kg/h in the PVB group (p = 0.003). Nine patients (31 %) in the control group, 8 patients (27 %) in the PVB group, and 6 patients (19 %) in the PB group required analgesia with promedol 2% after surgery (p = 0.542). The time to getting out of bed in the control, PB and PVB groups was 360 (150–360) min, 170 (120–240) min, and 162.5 (120–240) min, respectively (p = 0.003), and the time to the first meal was 360 (240–360) min, 165 (120–240) min, and 180 (120–220) min, respectively (p < 0.001). The incidence of PONV was the lowest in the PB group — 6 vs. 27 vs. 31 % in the PVB and control groups, respectively (p = 0.027). Conclusions. Among studied methods of analgesia in breast cancer surgery, the pectoral nerve block type II has the greatest advantages for enhanced recovery after surgery.

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