Comparative study of postoperative analgesia and opioid requirement using pectoral nerve blocks with general analgesia
Indian Journal of Surgery, cilt.83, ss.440-445, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 83
- Basım Tarihi: 2021
- Doi Numarası: 10.1007/s12262-021-02732-2
- Dergi Adı: Indian Journal of Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, Veterinary Science Database
- Sayfa Sayıları: ss.440-445
- Anahtar Kelimeler: Pectoral nerve block I, Pectoral nerve block II, Opioid-free anaesthesia, Breast surgery, Postoperative analgesia, Randomized controlled trial
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Breast cancer, which is the most common cancer in women, results to moderate to severe acute postoperative pain. Pectoral nerve block I and II, relatively new regional techniques, were introduced for perioperative and postoperative postmastectomy pain by Blanco in 2011 and 2012, respectively. The aim of this study is to evaluate the efficacy of combined pectoral nerve block I and pectoral nerve block II blocks for perioperative opioid consumption and postoperative analgesia and also contribute to new topic in anaesthesia: “Opioid-free anaesthesia is possible with combination of pectoral blocks in breast cancer surgery”. Sixty women patients of American Society of Anesthesiologists status I–III, aged ≥ 18 years undergoing breast surgeries, were included to study. Cases were randomly allocated to two groups: Group I, opioid-based general anaesthesia, and Group II, non-opioid general anaesthesia except induction of anaesthesia with pectoral nerve block I and pectoral nerve block II blocks. Patients demographic characteristics, intraoperative total remifentanil consumption, duration of surgery, first analgesic demand after surgery, nausea and vomiting, surgeon and patient satisfaction were recorded. Two groups were similar in terms of demographic features, surgery time, surgery type and vomiting. The mean remifentanil consumption in Group I was 8.63 mL (SD = 3.18) compared to mean = 1.73 mL (SD = 1.04) in Group II. Statistically lower remifentanil consumption was recorded in Group II than Group I. No patient developed nausea after surgery in Group II. Time for first analgesic demand after surgery for Group I and II were 35.00 (SD = 19.60) and 124.5 (SD = 99.00) minutes respectively. Time for first analgesic demand after surgery was statistically significant between the groups. Satisfaction scores were higher in Group II for both surgeon and patient. General anaesthesia combined with pectoral nerve block I and pectoral nerve block II blocks which is gaining acceptance over the world is safe and effective for breast surgery. We thought that further studies are necessary to investigate timing of blocks and combinations of blocks.