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BACKGROUND/AIM: Concurrent application of ultrasound-guided pectoral type 1 (PECS I) and serratus plane block (SPB) is one of the most appropriate multimodal analgesic strategies for reducing acute post-mastectomy pain. The purpose of the present study was to compare the analgesic efficacy of SPB alone, or in combination with PECS I block for post-mastectomy pain following breast cancer surgery. MATERIALS AND METHODS: Sixty participants undergoing breast cancer surgery were randomly assigned to two groups. After anesthesia induction, group S (n =30) received SPB alone, whereas the SPECS group (n =30) received a combination of PECS I and SPB. Pain scores at 0, 1, 2, 6, 12, 24 h postoperatively, intra-operative fentanyl consumption, postoperative time to first rescue analgesia, nausea, vomiting, patient satisfaction, and anesthesia-related complications were recorded. RESULTS: Pain scores in the SPECS group were significantly lower than group S throughout the follow-up period (p <0.001). A significant reduction in postoperative rescue morphine consumption (p =0.01, median difference 7 mg, 95 % confidence interval: 5.1-7.9 mg) and intraoperative fentanyl consumption (p =0.01) in the SPECS group compared with group S. Moreover, postoperative nausea and vomiting were lower, and patient satisfaction was higher in the SPECS group compared with that of the group S. CONCLUSIONS: These results suggest that SPB application and PECS I provide more effective and reliable perioperative analgesia and increase patient satisfaction in breast cancer surgery. HIPPOKRATIA 2021, 25 (1):8-14. TRIAL REGISTRATION NUMBER: NCT03899545.
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BACKGROUND: The aim of this retrospective study was to evaluate postoperative patients admitted to the intensive care unit (ICU) and to describe their characteristics and outcomes. METHODS: We performed a retrospective chart review of 1,756 postoperative patients admitted to the ICU of a tertiary referral hospital from January 2008 to December 2012. For each patient we recorded: demographic data, reason for admission to the ICU, duration of mechanical ventilation, elective versus emergency surgery, type of anaesthesia, American Society of Anesthesiologists (ASA) physical status, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow Coma Score (GCS), and outcome. RESULTS: During the study period, the rate of postoperative ICU admission increased each year, and the number of ICU beds was increased in order to perform a greater number of elective surgical procedures for patients who required postoperative ICU care. In 2008, 20.80 % of the patients were postoperatively admitted to the ICU; 58.97 % were in 2012. The mean ratio of five years was 46.97 %. Median age was 63 (1-94) years, and 57.4 % of the patients were male. The most common reasons for admission were major surgery (41.90 %) and comorbidities (34.10 %). Mortality rates were higher in patients that underwent emergency surgery, received general anesthesia, were operated on by a general surgeon, or had low GCS scores coupled with high ASA or APACHE II scores. CONCLUSIONS: The postoperative patients who had metabolic or hemodynamic instability, high ASA or APACHE II scores, and low GCS had higher mortality rates despite ICU care. Hippokratia 2016, 20(1): 38-43.