RESUMO
Post-mastectomy pain syndrome (PMPS) is a type of chronic postsurgical pain that can be severe, debilitating and frequently encountered in clinical practice. Multiple studies have focused on prevention, identifying risk factors and treating this condition. Nonetheless, PMPS remains a complex condition to treat effectively. In this case report, we describe the use of percutaneous electrical nerve stimulation in a breast cancer patient who experienced PMPS refractory to conventional treatments.
Assuntos
Neoplasias da Mama , Dor Crônica , Neuralgia , Estimulação Elétrica Nervosa Transcutânea , Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/complicações , Mastectomia/efeitos adversos , Estimulação Elétrica Nervosa Transcutânea/efeitos adversos , Dor Pós-Operatória/terapia , Neuralgia/terapia , Neuralgia/complicações , Dor Crônica/complicações , Dor Crônica/cirurgiaRESUMO
Regional anaesthetic techniques for patients undergoing laparotomy have been shown to provide optimal postoperative analgesia and allow early mobilisation, and thus, enhance recovery. The serratus anterior plane block, first documented in 2013, has been suggested as a potential alternative to thoracic paravertebral and central neuraxial blockade for chest wall and upper abdominal incisions as it can provide analgesia from T2 to T9. Although there are published cases of this block being used for chest wall analgesia, there are currently no published cases of this block being used for abdominal incisions. We report our experience with two patients, using ultrasound-guided serratus anterior plane blockade with catheter insertion following laparotomy.
Assuntos
Bloqueio Nervoso , Humanos , LaparotomiaRESUMO
Oral premedicant has better patient compliance since it avoids a potential needle prick, and hence can be considered closest to an ideal premedicant. This was a randomized prospective observational study on 120 patients after obtaining ethical committee approval and valid informed consent from patients to be part of the study. We assessed the onset and duration of both sensory and motor blocks along with postoperative analgesic requirement by the patient in terms of first dose and total dose required over the period of 24 hours. It is recommended that clonidine, etoricoxib, and gabapentin be considered as good premedicants for patients undergoing surgery under spinal anesthesia. However, more research using these drugs needs to be carried out in the field of premedication.