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Less use of rescue ...
Less use of rescue morphine when a combined PSP/IPP-block is used for postoperative analgesia in breast cancer surgery : A randomised controlled trial
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- Ahlberg, Hans (författare)
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Medicine (Östersund)
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- Wallgren, Daniel (författare)
- Department of Surgical and € Perioperative Sciences, Anaesthesiology and Intensive Care Medicine (Sunderbyn)
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- Hultin, Magnus, 1968- (författare)
- Umeå universitet,Anestesiologi och intensivvård
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- Myrberg, Tomi (författare)
- Department of Surgical and € Perioperative Sciences, Anaesthesiology and Intensive Care Medicine (Sunderbyn)
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- Johansson, Joakim (författare)
- Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Medicine (Östersund)
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(creator_code:org_t)
- Wolters Kluwer, 2023
- 2023
- Engelska.
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Ingår i: European Journal of Anaesthesiology. - : Wolters Kluwer. - 0265-0215 .- 1365-2346. ; 40:9, s. 636-642
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Surgery for breast cancer is common, and intravenous opioids are often used to control postoperative pain. Recently, pectoralis-2 (PECS-2) block has emerged as a promising regional anaesthetic alternative. With nomenclature recently proposed, this block is termed combined PSP/IPP-block (pectoserratus plane block/interpectoral plane block).OBJECTIVE: We aimed to compare the need for postoperative rescue morphine between the intervention group that received a pre-operative combined PSP/IPP-block and a control group that received peri-operative long-acting opioids for postoperative analgesia.DESIGN: A randomised controlled study.SETTING: Operating theatres of two Swedish hospitals. The patients were recruited between May 2017 and October 2020.PATIENTS: Among the 199 women scheduled to undergo breast cancer surgery (sector resection or radical mastectomy) who were enrolled in the study, 185 were available for follow up.INTERVENTION: All patients received general anaesthesia. The intervention group received a combined PSP/IPP-block before surgery. The control group received intravenous morphine 30 min before emergence from anaesthesia.MAIN OUTCOME MEASURE: The primary endpoint was the cumulative need for intravenous rescue morphine to reach a predefined level of pain control (visual analogue scale score <40 mm) during the first 48 h after surgery.RESULTS: Data from 92 and 93 patients in the intervention and control groups, respectively, were analysed. The amount of rescue morphine administered in the 48 h after surgery was significantly lower in the intervention group than in the control group (median: 2.25 vs 3.0 mg, P = 0.021). The first measured pain score was lower in the intervention group than in the control group (35 vs. 40 mm, P = 0.035). There was no significant difference in the incidence of nausea between the groups (8.7 vs. 12.9%, P = 0.357).CONCLUSION: The use of a combined PSP/IPP-block block before breast cancer surgery reduces the need for postoperative rescue morphine, even when compared with the use of intra-operative morphine.TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT03117894.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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- art (ämneskategori)
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