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1.
Ann Card Anaesth ; 27(1): 10-16, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38722115

RESUMO

BACKGROUND AND OBJECTIVE: Regional analgesia is effective for post-thoracotomy pain. The primary objective of the study is to compare the intraoperative requirement of isoflurane and fentanyl between general anaesthesia (GA) with epidural analgesia and GA with paravertebral analgesia. METHODS AND MATERIAL: A prospective observational comparative study was conducted on 56 patients undergoing open thoracotomy procedures. The patients were divided into two groups of 28 by assigning the study participants alternatively to each group: Group GAE - received thoracic epidural catheterization with GA, and Group GAP - received ultrasound guided thoracic paravertebral catheterization on the operative side with GA. Intraoperative requirement of isoflurane, fentanyl, postoperative analgesia, stress response, need of rescue analgesics and adverse effects were observed and analysed. RESULTS: 25 patients in each group were included in the data analysis. The intraoperative requirement of isoflurane (32.28 ± 1.88 vs 48.31 ± 4.34 ml; p < 0.0001) and fentanyl (128.87 ± 25.12 vs 157 ± 30.92 µg; p = 0.0009) were significantly less in the GAE group than in the GAP group. VAS scores and need of rescue analgesics and blood glucose levels were not statistically significant during the postoperative period (p > 0.05). The incidence of adverse effects was comparable except for hypotension and urinary retention which were significantly higher in the GAE group. CONCLUSION: GA with epidural analgesia resulted in significant reduction in the intraoperative consumption of isoflurane and fentanyl in comparison to GA with paravertebral analgesia. However, both the techniques were equally effective in the postoperative period.


Assuntos
Analgesia Epidural , Anestesia Geral , Fentanila , Dor Pós-Operatória , Toracotomia , Humanos , Feminino , Masculino , Toracotomia/métodos , Estudos Prospectivos , Pessoa de Meia-Idade , Anestesia Geral/métodos , Fentanila/administração & dosagem , Analgesia Epidural/métodos , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Adulto , Isoflurano/administração & dosagem , Anestésicos Inalatórios/administração & dosagem , Analgésicos/uso terapêutico , Analgésicos/administração & dosagem , Idoso , Bloqueio Nervoso/métodos
2.
Ann Card Anaesth ; 27(1): 58-60, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38722123

RESUMO

ABSTRACT: The transversus thoracic muscle plane (TTP) block is gaining widespread recognition in cardiac surgery, particularly in facilitating fast-tracking. Here, we report a case of inadvertent puncture of the right ventricle (RV) during the administration of ultra sound-guided (USG) TTP block in a 3-year-old child posted for atrial septal defect (ASD) closure and mitral valve repair. We also discuss the care that should be taken to avoid such complications and such cases require extra caution during TTP block.


Assuntos
Ventrículos do Coração , Humanos , Ventrículos do Coração/diagnóstico por imagem , Pré-Escolar , Comunicação Interatrial/cirurgia , Masculino , Ultrassonografia de Intervenção/métodos , Bloqueio Nervoso/métodos , Bloqueio Nervoso/efeitos adversos , Punções/efeitos adversos
3.
Ann Card Anaesth ; 27(1): 61-64, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38722124

RESUMO

ABSTRACT: A person with thoracolumbar scoliosis for cardiac surgery presents with problems of restrictive lung disease with the additional risk of reduced lung compliance and respiratory complications compared to the other patients. Post-operative analgesia in the form of continuous bilateral transversus thoracic muscle plane block (TTMPB) may help such patients in early respiratory rehabilitation by decreasing the time to extubation, reducing the opioid requirement, and early initiation of physiotherapy decreasing the risk of complications.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Bloqueio Nervoso , Escoliose , Humanos , Bloqueio Nervoso/métodos , Escoliose/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Analgesia/métodos , Masculino
5.
A A Pract ; 18(5): e01788, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38727139

RESUMO

Inability to remain motionless owing to pain during magnetic resonance imaging (MRI) may increase the need for sedation and analgesia. Here, we present a case where ultrasound-guided sacral erector spinae plane block (ESPB) was used successfully for pain management during an MRI in a patient suffering from severe sacral pain. Sacral ESPB was performed with a total of 30 mL of 0.25% bupivacaine at the level of the intermediate sacral crest. The patient achieved sensory block in the L5-S4 dermatomes without motor block, resulting in complete pain relief. This case report highlights the feasibility of ultrasound-guided sacral ESPB as a potential pain management technique.


Assuntos
Imageamento por Ressonância Magnética , Bloqueio Nervoso , Manejo da Dor , Ultrassonografia de Intervenção , Humanos , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Manejo da Dor/métodos , Bupivacaína/administração & dosagem , Anestésicos Locais/administração & dosagem , Feminino , Masculino , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/inervação , Pessoa de Meia-Idade , Sacro/diagnóstico por imagem , Sacro/inervação
6.
BMJ Open ; 14(5): e085680, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38697764

RESUMO

INTRODUCTION: Transversus abdominis plane (TAP) blocks are commonly used for postoperative analgesia after various abdominal surgeries. There are several different approaches for performing TAP blocks, mainly including posterior, lateral and subcostal approaches. An increasing number of randomised controlled trials (RCTs) have compared the analgesic effects of different TAP block approaches, but the results have not been consistent. This protocol aims to determine the optimal approach of ultrasound-guided TAP blocks for postoperative analgesia after abdominal surgery. METHODS AND ANALYSIS: Four databases, including Web of Science, PubMed, EMBASE and the Cochrane Library will be systematically searched to identify RCTs that compared the analgesic effects of different ultrasound-guided TAP block approaches. The search interval will range from the inception of the databases to 30 July 2024. The postoperative opioid consumption over 24 hours will be defined as the primary outcome. The secondary outcomes will include the analgesia duration, postoperative pain scores at rest and during movement at different timepoints and the incidence of adverse effects. All the statistical analyses will be conducted using RevMan V.5.4. The quality of evidence will be evaluated by the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION: Ethical approval will not be needed. The results will be submitted to one peer-reviewed journal when completed. PROSPERO REGISTRATION NUMBER: CRD42024510141.


Assuntos
Músculos Abdominais , Metanálise como Assunto , Bloqueio Nervoso , Dor Pós-Operatória , Revisões Sistemáticas como Assunto , Ultrassonografia de Intervenção , Humanos , Bloqueio Nervoso/métodos , Músculos Abdominais/inervação , Músculos Abdominais/diagnóstico por imagem , Ultrassonografia de Intervenção/métodos , Dor Pós-Operatória/prevenção & controle , Abdome/cirurgia , Projetos de Pesquisa , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
BMC Anesthesiol ; 24(1): 180, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773360

RESUMO

BACKGROUND: Although the efficacy and safety of epidural block (EB) are fairly high, complications such as inadvertent dural puncture may limit its use. Ultrasound-guided quadratus lumborum block (QLB) is a relatively new regional technique that provides perioperative somatic and visceral analgesia for pediatric patients. This trial compared the quality of pain relief in pediatric patients undergoing abdominal surgery who received either QLB or EB. METHODS: Patients were randomly allocated into two equal groups: Group E(n = 29): received EB; Group QL(n = 29): received QLB. Both groups were injected with 0.25% bupivacaine (0.5 ml/kg). Assessment of total analgesia consumption was the primary outcome measure, whereas the secondary outcome measures were assessment of postoperative analgesic effect by Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and time of first analgesic request. RESULTS: Our study showed that the mean total fentanyl consumption was comparable between both groups(38.67 ± 5.02 and 36.47 ± 5.13 µg in the E and QL groups, respectively, P = 0.246). Only five patients did not require rescue analgesia (3 in the E group,2 in the QL group, P = 0.378). The mean duration of analgesia showed no significant difference between the two groups (9.9 ± 1.58 and 11.02 ± 1.74 h in the E and QL groups, respectively, P = 0.212). Evaluation of CHEOPS score values immediately in PACU and for the initial 24 h following operation showed no significant difference between the two study groups(P > 0.05). CONCLUSION: QLB can achieve analgesic effects comparable to those of EB as a crucial part of multimodal analgesia in children undergoing abdominal surgeries. CLINICAL TRIAL REGISTRATION NUMBER: PACTR202203906027106.


Assuntos
Abdome , Músculos Abdominais , Bloqueio Nervoso , Dor Pós-Operatória , Ultrassonografia de Intervenção , Humanos , Masculino , Feminino , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Dor Pós-Operatória/prevenção & controle , Criança , Abdome/cirurgia , Pré-Escolar , Músculos Abdominais/diagnóstico por imagem , Anestésicos Locais/administração & dosagem , Bupivacaína/administração & dosagem , Analgesia Epidural/métodos , Fentanila/administração & dosagem , Analgésicos Opioides/administração & dosagem
8.
Medicine (Baltimore) ; 103(18): e38044, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38701299

RESUMO

BACKGROUND: Despite laparoscopic cholecystectomy (LC) is a commonly performed operation under ambulatory setting, significant postoperative pain is still a major concern. The ultrasound-guided subcostal approach of transversus abdominis plane (sTAP) blocks and wound infiltration (WI) are both widely practiced techniques to reduce postoperative pain in patients undergoing LC. Although these methods have been shown to relieve postoperative pain effectively, the relative analgesic efficacy between ultrasound-guided sTAP blocks and WI is not well known. METHODS: We searched PubMed, EMBASE, and CENTRAL to identify all randomized controlled trials (RCTs) comparing ultrasound-guided sTAP block versus WI for postoperative pain control in adult patients undergone LC. The search was performed until May 2023. Primary outcome was defined as 24-hour cumulative opioid consumption. Secondary outcomes were postoperative pain scores and the incidence of postoperative nausea and vomiting (PONV). RESULTS: Finally, 6 RCTs were included, and data from 314 participants were retrieved. Postoperative 24-hour opioid consumption was significantly lower in ultrasound-guided sTAP group than in the WI group with a mean difference of -6.67 (95% confidence interval: -9.39 to - 3.95). The ultrasound-guided sTAP group also showed significantly lower pain scores. Incidence of PONV did not significantly differ between the 2 groups. CONCLUSIONS: We conclude that there is low to moderate evidence to advocate that ultrasound-guided sTAP block has better analgesic effects than WI in patients undergoing LC. Further trials are needed with robust methodology and clearly defined outcomes.


Assuntos
Músculos Abdominais , Colecistectomia Laparoscópica , Bloqueio Nervoso , Dor Pós-Operatória , Ultrassonografia de Intervenção , Humanos , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/etiologia , Bloqueio Nervoso/métodos , Colecistectomia Laparoscópica/métodos , Colecistectomia Laparoscópica/efeitos adversos , Ultrassonografia de Intervenção/métodos , Músculos Abdominais/inervação , Ensaios Clínicos Controlados Aleatórios como Assunto , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico
10.
Minerva Anestesiol ; 90(5): 427-438, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38771166

RESUMO

INTRODUCTION: Peripheral nerve block, a common technique for managing postoperative pain and providing intraoperative analgesia, often includes adjuncts like dexmedetomidine (DEX) to enhance the effectiveness of local anesthetics. DEX, known for its α2-adrenoceptor agonist properties, extends sensory blockade and improves postoperative analgesia while offering sedative benefits. The objective of this study is to rigorously assess the effectiveness and safety of perineural DEX injection in orthopedic nerve block procedures, focusing on orthopedic surgeries to minimize heterogeneity and provide clearer insights for clinical practice. EVIDENCE ACQUISITION: This meta-analysis, registered on PROSPERO, involved a comprehensive literature search across multiple databases, focusing on RCTs comparing DEX with local anesthetics for peripheral nerve blocks in orthopedic surgery patients. The eligibility criteria included adult participants and various nerve block methods in orthopedic surgeries. Studies were rigorously appraised for methodological quality using Cochrane Handbook guidelines. GRADE profiler 3.6 was used for evidence grading. EVIDENCE SYNTHESIS: Among 1391 documents, 21 studies were included, focusing on DEX with local anesthetics in orthopedic nerve blocks. Findings showed significant improvements in analgesia duration, sensory and motor block duration, and reduced postoperative opioid consumption, with an increased risk of bradycardia. Quality assessments indicated moderate bias risk. CONCLUSIONS: DEX with local anesthetics significantly enhances nerve block effectiveness, extending analgesia and block durations while reducing opioid need. However, it requires careful monitoring due to increased bradycardia risk. These findings highlight the need for cautious use in clinical practice, considering both potential benefits and adverse effects.


Assuntos
Anestésicos Locais , Dexmedetomidina , Bloqueio Nervoso , Procedimentos Ortopédicos , Dexmedetomidina/uso terapêutico , Humanos , Bloqueio Nervoso/métodos , Anestésicos Locais/uso terapêutico , Analgésicos não Narcóticos/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Resultado do Tratamento
14.
Braz J Cardiovasc Surg ; 39(2): e20230354, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748605

RESUMO

Postoperative pain after cardiac surgery plays an important role in the patient's recovery process. In particular, pain at the chest tube site can negatively affect the comfort and recovery of these patients. Effective pain control minimizes the risk of many complications. Oral and intravenous analgesics, epidural anesthesia, paravertebral block, and intercostal nerve blockade are used in chest tube pain control. We routinely use the surgical cryoablation method in the presence of atrial fibrillation in the preoperative period of cardiac surgery in our clinic. Here we aimed to describe our method of using the cryoablation catheter for intercostal nerve blockade.


Assuntos
Fibrilação Atrial , Tubos Torácicos , Criocirurgia , Dor Pós-Operatória , Humanos , Fibrilação Atrial/cirurgia , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/etiologia , Criocirurgia/métodos , Criocirurgia/instrumentação , Bloqueio Nervoso/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Nervos Intercostais , Resultado do Tratamento , Catéteres
15.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(5): 556-561, 2024 May 15.
Artigo em Chinês | MEDLINE | ID: mdl-38752241

RESUMO

Objective: To compare the effect of sciatic nerve block (SNB) combined with continuted femoral nerve block (FNB) or continuted adductor canal block (ACB) on pain and motor function after total knee arthroplasty (TKA). Methods: A total of 60 patients with TKA-treated osteoarthritis of the knee who met the selection criteria were enrolled between November 2020 and February 2021 and randomised allocated into the study group (SNB combined with continuted ACB) and the control group (SNB combined with continuted FNB), with 30 cases in each group. There was no significant difference in gender, age, body mass, height, body mass index, preoperative Hospital for Special Surgery (HSS) score, femoral tibial angle, and medial proximal tibial angle between the two groups ( P>0.05). The operation time, the initial time to the ground, the initial walking distance, and the postoperative hospital stay were recorded. At 2, 4, 6, 12, 24, and 48 hours after operation, the numerical rating scale (NRS) score was used to evaluate the rest pain around the knee joint, the quadriceps femoris muscle strength was evaluated by the freehand muscle strength method, and the knee flexion and extension angles were measured. Results: There was no significant difference in the operation time and initial walking distance between the two groups ( P>0.05); the initial time to the ground and postoperative hospital stay of the study group were significantly shorter than those of the control group ( P<0.05). Except for the 48-hour postoperative NRS score of the study group, which was significantly lower than that of the control group ( P<0.05), there was no significant difference in the NRS scores between the two groups at the remaining time points ( P>0.05). The quadriceps femoris muscle strength from 4 to 24 hours postoperatively and the knee extension angle from 2 to 6 hours postoperatively of the study group were significantly better than those of the control group ( P<0.05); the differences in the quadriceps femoris muscle strength and knee extension and flexion angles between the two groups at the remaining time points were not significant ( P>0.05). Conclusion: SNB combined with either continuted ACB or continuted FNB can effectively relieve pain in patients after TKA, and compared with combined continuted FNB, combined continuted ACB has less effect on quadriceps femoris muscle strength, and patients have better recovery of knee flexion and extension mobility.


Assuntos
Artroplastia do Joelho , Nervo Femoral , Bloqueio Nervoso , Dor Pós-Operatória , Nervo Isquiático , Humanos , Artroplastia do Joelho/métodos , Bloqueio Nervoso/métodos , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Osteoartrite do Joelho/cirurgia , Feminino , Masculino , Medição da Dor , Duração da Cirurgia , Idoso , Tempo de Internação
16.
Anaesthesiol Intensive Ther ; 56(1): 54-60, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38741444

RESUMO

INTRODUCTION: Neuraxial anaesthesia is a common choice for most hip and lower limb operations. Pain associated with positioning is often a deterrent, and the vast literature suggests different regional blocks and opioids for these patients. Patients with acetabular fractures may experience increased pain, and thus are more difficult to position for the neuraxial block. We conducted a randomized controlled pilot study to assess and compare the analgesic efficacy of ultrasound-guided suprainguinal fascia iliaca block (SFICB) versus systemic fentanyl to facilitate positioning for combined spinal epidural (CSE) anaesthesia in patients undergoing acetabular fracture surgery. MATERIAL AND METHODS: Twenty patients referred for surgical repair of acetabular fractures were randomly assigned to receive either ultrasound-guided SFICB (group B) or intravenous fentanyl (group F). Changes in visual analogue scale (VAS) scores in supine and sitting position, improvement in sitting angle (SA), positioning quality, rescue analgesic requirement, total opioid consumption, comfort VAS scores, and complications were noted to compare both groups. RESULTS: The post-intervention VAS score in the sitting position was significantly lower in group B than in group F (5.9 ± 2.1 vs. 3.5 ± 1.5, P = 0.01). Group B also had more significant improvement in SA (27.5° (20.75-36.5°), in comparison to group F (10 (5-18.75), P = 0.006). The positioning quality was better in group B, with 70% of patients achieving an optimal position compared to only 10% in group F ( P = 0.02). CONCLUSIONS: Ultrasound-guided SFICB, as compared to systemic fentanyl, provided better analgesia and helped to achieve a better and more comfortable position to perform the neuraxial block.


Assuntos
Acetábulo , Fentanila , Bloqueio Nervoso , Posicionamento do Paciente , Ultrassonografia de Intervenção , Humanos , Projetos Piloto , Masculino , Feminino , Ultrassonografia de Intervenção/métodos , Bloqueio Nervoso/métodos , Acetábulo/cirurgia , Adulto , Pessoa de Meia-Idade , Fentanila/administração & dosagem , Posicionamento do Paciente/métodos , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Fáscia , Fraturas Ósseas/cirurgia , Raquianestesia/métodos , Medição da Dor , Anestesia Epidural/métodos
17.
Anesthesiol Clin ; 42(2): 219-231, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38705672

RESUMO

Shoulder surgery introduces important anesthesia considerations. The interscalene nerve block is considered the gold standard regional anesthetic technique and can serve as the primary anesthetic or can be used for postoperative analgesia. Phrenic nerve blockade is a limitation of the interscalene block and various phrenic-sparing strategies and techniques have been described. Patient positioning is another important anesthetic consideration and can be associated with significant hemodynamic effects and position-related injuries.


Assuntos
Ombro , Humanos , Ombro/cirurgia , Anestesia/métodos , Bloqueio Nervoso/métodos , Posicionamento do Paciente/métodos
18.
Anesthesiol Clin ; 42(2): 203-217, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38705671

RESUMO

Upper extremity injuries are frequent in athletes which may require surgeries. Regional anesthesia for postoperative analgesia is important to aid recovery, and peripheral nerve blocks for surgical anesthesia enable surgeries to be performed without general anesthetics and their associated adverse effects. The relevant nerve block approaches to anesthetize the brachial plexus for elbow, wrist and hand surgeries are discussed in this article. There is very limited margin for error when performing nerve blocks and multimodal monitoring approach to reduce harm are outlined. Lastly, the importance of obtaining informed consent prior to nerve block procedures should not be overlooked.


Assuntos
Anestesia por Condução , Atletas , Bloqueio Nervoso , Extremidade Superior , Humanos , Anestesia por Condução/métodos , Extremidade Superior/cirurgia , Bloqueio Nervoso/métodos
19.
Eur Rev Med Pharmacol Sci ; 28(8): 3066-3072, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38708465

RESUMO

OBJECTIVE: The aim of the study was to determine the optimal position for femoral nerve block (FNB) under ultrasound guidance. PATIENTS AND METHODS: We included fifty volunteers between 18-65 years of age in this study. The distances from the skin to the landmarks, which were taken as a reference for the ultrasound-guided FNB (apex point of the femoral artery = F12, lateral point = F9, and lower point = F6), were measured and compared in 3 different positions given to the lower extremity (neutral position: P1, 45° abduction: P2, and flexed knee: P3). The ease of application and the quality of the ultrasound images were evaluated at each measurement by assigning a subjective observer score and comparing them in three positions. RESULTS: All three measurement points were found to be closest to the skin at position P3. However, the distances from F9 (p = 0.023) and F6 (p = 0.006) to the skin were significant. A significant difference was found between P1 and P3 in terms of the distance from F9 (p = 0.027) and F6 to the skin (p = 0.007). P3 was determined to be the position with the highest score for clarity of the ultrasonography images and ease of detection of the measurement points (p < 0.001). As the scores of ease of access to the femoral nerve (FN) and image clarity increased, the distance from the measurement point to the skin surface decreased, which was statistically significant. CONCLUSIONS: The ideal position for ultrasound-guided FNB is the P3 position. As an alternative for patients with limited mobility, the P2 position can be used.


Assuntos
Nervo Femoral , Extremidade Inferior , Bloqueio Nervoso , Humanos , Nervo Femoral/diagnóstico por imagem , Bloqueio Nervoso/métodos , Adulto , Estudos Prospectivos , Pessoa de Meia-Idade , Extremidade Inferior/diagnóstico por imagem , Adulto Jovem , Masculino , Feminino , Idoso , Adolescente , Ultrassonografia de Intervenção/métodos , Ultrassonografia
20.
Eur Rev Med Pharmacol Sci ; 28(8): 3120-3134, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38708471

RESUMO

OBJECTIVE: Breast cancer, a prevalent global malignancy in women, necessitates a comprehensive treatment approach, with surgery playing a crucial role. Severe acute pain is common post-radical breast cancer surgery, emphasizing the significance of hemodynamic stability and postoperative pain control for optimal outcomes. This study evaluates the impact of ultrasound-guided erector spinae plane block (ESPB) on these parameters in ASA scores 1-2 patients undergoing modified radical breast cancer surgery with general anesthesia. PATIENTS AND METHODS: Forty-eight patients were divided into two groups: a general anesthesia group, with erector spinae plane block (GA+ESPB), and a control group receiving only general anesthesia (GA). Hemodynamic parameters were continuously monitored, and postoperative pain was assessed using the visual analog scale (VAS) at various time points. RESULTS: Ultrasound-guided ESPB effectively maintained hemodynamic stability and reduced postoperative pain in breast cancer surgery patients. Statistically significant differences were observed in heart rate, systolic and diastolic blood pressure, and mean arterial pressure between the GA and GA+ESPB groups at multiple time points (p < 0.05). VAS scores showed a significant interaction time*group (p < 0.001), with consistent differences between the groups at all time points (p ≤ 0.001). CONCLUSIONS: Ultrasound-guided ESPB application proved effective in preserving hemodynamic stability and managing postoperative pain in modified radical breast cancer surgery. The technique demonstrates promise in minimizing complications related to hemodynamic variations and postoperative pain, contributing to a comprehensive approach to breast cancer surgical treatment.


Assuntos
Neoplasias da Mama , Hemodinâmica , Mastectomia Radical Modificada , Bloqueio Nervoso , Dor Pós-Operatória , Ultrassonografia de Intervenção , Humanos , Feminino , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/etiologia , Neoplasias da Mama/cirurgia , Bloqueio Nervoso/métodos , Hemodinâmica/efeitos dos fármacos , Pessoa de Meia-Idade , Adulto , Anestesia Geral , Idoso
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