Abstract:
BACKGROUND:Several locoregional techniques have been described for the management of acute and chronic pain after breast surgery. The optimal technique should be easy to perform, reproducible, with little discomfort to the patient, little complications, allowing good control of acute pain and a decreased incidence of chronic pain, namely intercostobrachial neuralgia for being the most frequent entity. OBJECTIVES:The aim of this study was to evaluate the paravertebral block with preoperative single needle prick for major breast surgery and assess initially the control of postoperative nausea and vomiting (PONV) and acute pain in the first 24hours and secondly the incidence of neuropathic pain in the intercostobrachial nerve region six months after surgery. METHODS:The study included 80 female patients, ASA I-II, aged 18-70 years, undergoing major breast surgery, under general anesthesia, stratified into 2 groups: general anesthesia (inhalation anesthesia with opioids, according to hemodynamic response) and paravertebral (paravertebral block with single needle prick in T4 with 0.5% ropivacaine + adrenaline 3μg/mL with a volume of 0.3mL/kg preoperatively and subsequent induction and maintenance with general inhalational anesthesia). In the early postoperative period, patient-controlled analgesia (PCA) was placed with morphine set for bolus on demand for 24hours. Intraoperative fentanyl, postoperative morphine consumption, technique-related complications, pain at rest and during movement were recorded at 0h, 1h, 6h and 24h, as well as episodes of PONV. All variables identified as factors contributing to pain chronicity age, type of surgery, anxiety according to the Hospital Anxiety and Depression Scale (HADS), preoperative pain, monitoring at home; body mass index (BMI) and adjuvant chemotherapy/radiation therapy were analyzed, checking the homogeneity of the samples. Six months after surgery, the incidence of neuropathic pain in the intercostobrachial nerve was assessed using the DN4 scale. RESULTS:The Visual Analogue Scale (VAS) values of paravertebral group at rest were lower throughout the 24hours of study 0h 1.90 (± 2.59) versus 0.88 (± 1.5) 1h 2.23 (± 2.2) versus 1.53 (± 1.8) 6h 1.15 (± 1.3) versus 0.35 (± 0.8); 24h 0.55 (± 0.9) versus 0.25 (± 0.8) with statistical significance at 0h and 6h. Regarding movement, paravertebral group had VAS values lower and statistically significant in all four time points: 0h 2.95 (± 3.1) versus 1.55 (± 2.1); 1h 3.90 (± 2.7) versus 2.43 (± 1.9) 6h 2.75 (± 2.2) versus 1.68 (± 1.5); 24h 2.43 (± 2.4) versus 1.00 (± 1.4). The paravertebral group consumed less postoperative fentanyl (2.38±0.81μg/kg versus 3.51±0.81μg/kg) and morphine (3.5mg±3.4 versus 7mg±6.4) with statistically significant difference. Chronic pain evaluation of at 6 months of paravertebral group found fewer cases of neuropathic pain in the intercostobrachial nerve region (3 cases versus 7 cases), although not statistically significant. CONCLUSIONS:Single-injection paravertebral block allows proper control of acute pain with less intraoperative and postoperative consumption of opioids but apparently it cannot prevent pain chronicity. Further studies are needed to clarify the role of paravertebral block in pain chronicity in major breast surgery.
journal_name
Rev Bras Anestesioljournal_title
Revista brasileira de anestesiologiaauthors
Gacio MF,Lousame AM,Pereira S,Castro C,Santos Jdoi
10.1016/j.bjan.2015.12.002subject
Has Abstractpub_date
2016-09-01 00:00:00pages
475-84issue
5eissn
0034-7094issn
1806-907Xpii
S0034-7094(15)00175-0journal_volume
66pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:Microspheres can be used as a controlled delivery system to prolong the duration of action of local anesthetics. The objective of this study was the preparation, characterization and analysis of the in vitro release of 50% enantiomeric excess bupivacaine (S75-R25)-loaded microspheres. METHODS...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942008000100003
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Although acute and chronic pain are usually controlled with pharmacological interventions, 14 complementary methods of adjuvant and alternative analgesia (AAA) may reduce the abusive prescription of analgesics and the side effects that eventually compromise the patient's physiological status. ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942006000500012
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Clinical trials with local anesthetic levo-enantiomers have shown higher safety due to lower cardiotoxicity. This study aimed at evaluating quality of anesthesia and maternal/fetal repercussions of 0.5% bupivacaine, enantiomeric 0.5% bupivacaine (S75-R25) and 0.75% ropivacaine, all associated ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942003000200005
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Dilated cardiomyopathy is a state of progressive enlargement of cardiac chambers mainly left ventricle which leads to decreased cardiac output and ultimately cardiac failure. Although it has multifactorial etiology, it is quite common in patients with end stage renal disease who require renal ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2019.06.002
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The incidence of difficult airway reaches 10% of emergency intubations. Although few studies address the use of handmade introducer guides in emergency and intensive care environment, there are descriptions of handmade guides available on the Internet. We describe a case series on the use of a...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2013.06.021
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The inadequate use of basic statistics is the main responsible for scientific article misinterpretation. The purpose of this review article was to review some basic statistical topics to alert authors and readers about the importance of basic statistics proper reporting. CONTENT:A bibliographi...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章,评审
doi:10.1016/j.bjan.2017.01.003
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:It is known that acute postoperative pain has a major influence on surgical patients recovery. Early movements, shorter hospital stay, lower costs and higher satisfaction are results of adequate pain management. There is a world trend toward specialized postoperative pain management services. ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942003000600012
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Minimum anesthetic volume (MAV) of local anesthetics corresponds to the effective volume for regional anesthesia in 50% of patients. In this study, MAV of 0.5% racemic bupivacaine, 0.5% levobupivacaine and enantiomeric S75/R25 bupivacaine were calculated and compared. METHODS:This study invol...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942005000300002
更新日期:2005-06-01 00:00:00
abstract:PURPOSE:Ischemia-reperfusion injury is one of the consequences of tourniquet application for extremity surgery. The aim of the study was to establish the effect of dexmedetomidine on the acute lung injury following lower extremity experimental ischemia-reperfusion model in rats. METHODS:Twenty-eight Wistar-Albino bree...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2016.09.004
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributab...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2016.09.002
更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:Blood is an important resource in several lifesaving interventions, such as anemia correction and improvement of oxygen transport capacity. Despite advances, packed red blood cell (PRBC) transfusion still involves risks. The aim of this study was to describe the knowledge of anesthesiologists about the ind...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2016.09.011
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Deep analgesia of burned patients needing daily care of their injuries is a field where references are very scarce in the literature. This study aimed at evaluating balneotherapy anesthetic technique in 2852 procedures. METHODS:A one-year period prospective evaluation was performed on sedativ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942004000200010
更新日期:2004-04-01 00:00:00
abstract::Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isol...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2017.09.004
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Porphyrias represent a group of inherited or acquired disorders that involve enzymes that participate in heme synthesis. Acute manifestations affect the nervous system resulting in abdominal pain, vomiting, acute neuropathy, seizures, and mental disorders. The physiopathogeny results from the ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/S0034-7094(10)70079-9
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The adequate maintenance of inhaled gases temperature during anesthetic procedures is critical to prevent perioperative respiratory complications. This study aimed at comparing the ability to warm up inhaled gases of coaxial breathing system and conventional system, by varying fresh gas flows ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942005000100008
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Von Willebrand's disease is the most common hereditary coagulation disorder in young women. The incidence of HIV infection among women has been progressively increasing, and vertical transmission may account for 25% of cases. This report aimed at describing the case of an HIV-positive patient ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942004000600006
更新日期:2004-12-01 00:00:00
abstract:INTRODUCTION:Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective su...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2018.04.001
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Trigeminocardiac reflex is a physiological phenomenon that may occur in head and neck surgery, and is usually benign. However, it may present with exaggerated responses with severe morbidity. CASE REPORT:Male patient, 26 years old, candidate for surgical treatment of zygomatic-orbital complex fracture. The ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2018.11.003
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Postoperative dysphonia is commonly associated to tracheal intubation and extubation complications, but other causal factors may be involved, including surgical procedures. This article aimed at reporting a late postoperative dysphonia as a consequence of left vocal cord paralysis secondary to...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In shoulder arthroscopy, on an outpatient basis, the patient needs a good control of the postoperative pain that can be achieved through regional blocks. Perineural dexamethasone may prolong the effect of these blocks. The aim of this study was to evaluate the effect of perineural dexamethason...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2020.07.003
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Some studies showed that ketamine inhibits the production of cytokines. The objective of this study was to evaluate the preemptive analgesic effect of epidural S(+)-ketamine in hysterectomy and plasmatic cytokines (IL-6, TNF-α and IL-10). METHOD:A double-blinded study with 29 patients was con...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章,随机对照试验
doi:10.1016/S0034-7094(12)70097-1
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In Brazil, the use of information systems that allows filling out anesthesia reports automatically is still in its initial stages. The objective of this study was to validate an automated anesthesia record. METHODS:This study was approved by the Ethics Commission of the institution; an indust...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/S0034-7094(10)70036-2
更新日期:2010-05-01 00:00:00
abstract::The use of analgesia techniques for labor has become increasingly frequent, with neuraxial techniques being the most commonly used and most effective. Labor pain entails a number of physiological consequences that may be negative for the mother and fetus, and therefore must be treated. This literature review was perfo...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章,评审
doi:10.1016/j.bjan.2018.12.001
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Maintaining target-controlled propofol blood concentrations in approximately constant levels is a technique that can be used in a simple way in the operating room. The aim of this study was to compare in clinical and laboratorial terms propofol infusion in children, using Shorts and Marshs pha...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942002000300002
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Anesthesia and surgery often promote significant temperature changes. Hypothermia during anesthesia is the most common perioperative thermal disorder. This report describes an unusual body heat balance change associated to spinal morphine. CASE REPORT:Female patient, 44 years old, physical st...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942006000100007
更新日期:2006-02-01 00:00:00
abstract::We presented a 39-year-old female patient with life-threatening hypoxemia after tricuspid valve replacement because of Ebstein's anomaly. And the severe cyanosis is due to bioprosthetic valve stenosis and atrial septal defect. Anesthetic management of a patient with severe obstructive prosthetic valve dysfunction can ...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2018.06.010
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Inhalation anesthetics are used in human, as well as veterinary medical practice. In the present study we investigated the effect of isoflurane and sevoflurane on rat hepatocytes. METHODS:A total of 40 Wistar female rats were used in this study. Animals were divided in groups of 5 rats. Group...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2015.09.007
更新日期:2016-09-01 00:00:00
abstract:INTRODUCTION:The primary purpose of this study was to compare the effect of high fidelity simulation versus a computer-based case solving self-study, in skills acquisition about malignant hyperthermia on first year anesthesiology residents. METHODS:After institutional ethical committee approval, 31 first year anesthes...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2018.01.005
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. OBJECTIVE:The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. DESIGN:Prospective, randomized, placebo controlled, double blin...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1016/j.bjan.2016.01.003
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Problems with pediatric airways are among the greatest challenges an anesthesiologist can face. Laryngeal spasm, which is twice or three times more frequent in the pediatric population, is paramount. The objective of this work was to report the treatment of laryngeal spasm applying digital pre...
journal_title:Revista brasileira de anestesiologia
pub_type: 杂志文章
doi:10.1590/s0034-70942008000600008
更新日期:2008-11-01 00:00:00