JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (11)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kairaluoma, P. M.
Right arrow Articles by Pere, P. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kairaluoma, P. M.
Right arrow Articles by Pere, P. J.
Related Collections
Right arrow Surgery
Right arrow Regional Anesthesia
Right arrow Pharmacology

Anesth Analg 2004;99:1837-1843
© 2004 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000136775.15566.87

REGIONAL ANESTHESIA

Single-Injection Paravertebral Block Before General Anesthesia Enhances Analgesia After Breast Cancer Surgery With and Without Associated Lymph Node Biopsy

Pekka M. Kairaluoma, MD*, Martina S. Bachmann, MD, PhD*, Aulikki K. Korpinen, MD{dagger}, Per H. Rosenberg, MD, PhD*, and Pertti J. Pere, MD, PhD*

*Department of Anesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland; and {dagger}Rheumatism Foundation Hospital, Heinola, Finland

Address correspondence and reprint requests to Pekka M. Kairaluoma, MD, Department of Anesthesia and Intensive Care Medicine, Helsinki University Hospital, PO Box 580, Helsinki, FIN-00029 HUS, Finland. Address e-mail to pekka.kairaluoma{at}hus.fi

Paravertebral block (PVB) seems to decrease postoperative pain and postoperative nausea and vomiting (PONV) after breast surgery, but the studies have not been placebo controlled. We studied 60 patients scheduled for breast cancer surgery randomly given single-injection PVB at T3 with bupivacaine 5 mg/mL (1.5 mg/kg) or saline before general anesthesia. The patient and attending investigators were blinded; the PVB or the sham block was performed behind a curtain by an anesthesiologist not involved in the study. The patients given PVB with bupivacaine needed 40% less IV opioid medication (primary outcome variable) in the postanesthesia care unit, had a longer latency to the first opioid dose, and had less pain at rest after 24 h than the control patients (P < 0.01). They also had less PONV in the postanesthesia care unit (P < 0.05), were less sedated until 90 min (P < 0.05), and performed better in the digit symbol substitution test at 90 min and the ocular coordination test 60–120 min after surgery (P < 0.05). The average peak bupivacaine plasma concentration was 750 ng/mL. One patient had bilateral convulsions immediately after bupivacaine injection. We conclude that PVB before general anesthesia for breast cancer surgery reduced postoperative pain, opioid consumption, and occurrence of PONV and improved recovery from anesthesia.

IMPLICATIONS: Preoperative single-injection paravertebral block proved a suitable adjunct to a multimodal analgesic regimen: it improved postoperative analgesia and prevented postoperative nausea and vomiting after breast resection or mastectomy with and without associated axillary dissection.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
J. McElwain, N. M. Freir, C. L. Burlacu, D. C. Moriarty, D. I. Sessler, and D. J. Buggy
The Feasibility of Patient-Controlled Paravertebral Analgesia for Major Breast Cancer Surgery: A Prospective, Randomized, Double-Blind Comparison of Two Regimens
Anesth. Analg., August 1, 2008; 107(2): 665 - 668.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
T. Sidiropoulou, O. Buonomo, E. Fabbi, M. B. Silvi, G. Kostopanagiotou, A. F. Sabato, and M. Dauri
A Prospective Comparison of Continuous Wound Infiltration with Ropivacaine Versus Single-Injection Paravertebral Block After Modified Radical Mastectomy
Anesth. Analg., March 1, 2008; 106(3): 997 - 1001.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
J. F. Moller, L. Nikolajsen, S. A. Rodt, H. Ronning, and P. S. Carlsson
Thoracic Paravertebral Block for Breast Cancer Surgery: A Randomized Double-Blind Study
Anesth. Analg., December 1, 2007; 105(6): 1848 - 1851.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
P. M. Kairaluoma, M. S. Bachmann, P. H. Rosenberg, and P. J. Pere
Preincisional paravertebral block reduces the prevalence of chronic pain after breast surgery.
Anesth. Analg., September 1, 2006; 103(3): 703 - 708.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
A. Vogt, D. S. Stieger, C. Theurillat, and M. Curatolo
Single-injection thoracic paravertebral block for postoperative pain treatment after thoracoscopic surgery
Br. J. Anaesth., December 1, 2005; 95(6): 816 - 821.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2004 by the International Anesthesia Research Society.