Recurrence of breast cancer after regional or general anaesthesia: a randomised controlled trial

Publication date: Available online 20 October 2019Source: The LancetAuthor(s): Daniel I Sessler, Lijian Pei, Yuguang Huang, Edith Fleischmann, Peter Marhofer, Andrea Kurz, Douglas B Mayers, Tanja A Meyer-Treschan, Martin Grady, Ern Yu Tan, Sabry Ayad, Edward J Mascha, Donal J Buggy, Gang Tan, Zhiyong Zhang, Helen Keane, Maurice Stokes, Oliver Zotti, Michael Gnant, Silvia Perez-ProttoSummaryBackgroundThree perioperative factors impair host defence against recurrence during cancer surgery: the surgical stress response, use of volatile anaesthetic, and opioids for analgesia. All factors are ameliorated by regional anaesthesia-analgesia. We tested the primary hypothesis that breast cancer recurrence after potentially curative surgery is lower with regional anaesthesia-analgesia using paravertebral blocks and the anaesthetic propofol than with general anaesthesia with the volatile anaesthetic sevoflurane and opioid analgesia. A second hypothesis was that regional anaesthesia-analgesia reduces persistent incisional pain.MethodsWe did a randomised controlled trial at 13 hospitals in Argentina, Austria, China, Germany, Ireland, New Zealand, Singapore, and the USA. Women (age
Source: The Lancet - Category: General Medicine Source Type: research

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ConclusionsPecs2 blocks can significantly reduce post-operative pain, nausea and vomiting in patients undergoing mastectomy. Their use can enable units to achieve high day-case mastectomy rates.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Conditions:   Anesthesia;   Analgesia;   Acute Pain;   Chronic Pain;   Pectoralis Nerve Block;   Erector Spine Plane Block;   Patient Controlled Analgesia Interventions:   Procedure: Pectoralis nerve block;   Procedure: Erector spine plane block;   Other: Control Sponsors:   Ondokuz Mayıs University;   CENGİZ KAYA (ckaya) Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
This study tested the hypothesis that vascular endothelial growth factor A and vascular endothelial growth factor receptor 2 contribute to bone cancer pain regulation associated with spinal central sensitization.Methods This study was performed on female rats using a metastatic breast cancer bone pain model. Nociceptive behaviors were evaluated by mechanical allodynia, thermal hyperalgesia, spontaneous pain, and CatWalk gait analysis. Expression levels were measured by real-time quantitative polymerase chain reaction, western blot, and immunofluorescence analysis. Excitatory synaptic transmission was detected by whole-cell...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Authors: Cassai A, Bonanno C, Sandei L, Finozzi F, Carron M, Marchet A Abstract Background: Breast cancer is complicated by a high incidence of chronic postoperative pain (25%-60%). Regional anesthesia might play an important role in lowering the incidence of chronic pain; however it is not known if the pectoral nerve block (PECS block), which is commonly used for breast surgery, is able to prevent this complication. Our main objective was therefore to detect any association between the PECS block and chronic pain at 3, 6, 9, and 12 months in patients undergoing breast surgery. Methods: We conducted a prospecti...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
AbstractPurposeThe aim of the present study was to determine the levels of anxiety of partners of breast cancer patients and to evaluate the differences of anxiety levels between patients and partners according to the stage of treatment, age and education level.Methods57 spouses or domestic partners of breast cancer patients and 148 breast cancer patients participated in this prospective cohort study and filled out the questionnaires including the Spielberger state-trait-anxiety-inventory, as well as questions based on stress-triggering procedures during breast cancer diagnosis and therapy.ResultsState anxiety levels of pa...
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
CONCLUSIONS: After mostly minor surgery for breast cancer, PECS II block was not superior to local infiltration by the surgeon. PMID: 31490251 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
ConclusionUltrasound guided infiltration allows accurate placement of large volume of diluted local anaesthetic solution safely and provides effective anaesthesia.
Source: The Surgeon - Category: Surgery Source Type: research
Editor ’s PerspectiveWhat We Already Know about This TopicPectoralis-II block is a potential alternative to paravertebral blocks to provide regional analgesia for breast cancer surgeryWhat This Article Tells Us That Is NewThis meta-analysis includes 14 randomized trials comparing pectoralis-II block with paravertebral blocks and found that there were no differences in pain scores or opioid consumption between the two groups in patients having surgery for breast cancerPectoralis-II blocks were noninferior to paravertebral blocks in reducing pain intensity and morphine consumption for the first 24 h after surgery and b...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Conclusion: PECS II block is a more effective block when compared to ESP block in patients of MRM in terms of postoperative analgesia and opioid consumption.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Rakhi Khemka, Arunangshu Chakrborty, Sanjit Agrawal, Rosina AhmedIndian Journal of Anaesthesia 2019 63(7):530-536 Background and Aims: Pecs block and its variations provides perioperative analgesia, reduce PONV and other opioid related side effects. We hypothesized that COMIBPES block in addition to general anaesthesia will provide better postoperative analgesia when compared to general anaesthesia alone in breast cancer surgery patients. Methods: After obtaining permission from the institutional review board and registering the trial with Clinical Trials Registry of India (CTRI), we conducted a double blinded randomized ...
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
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