{"title":"Comparação entre duas doses de ácido tranexâmico intra‐articular no sangramento pós‐operatório de artroplastia total do joelho: estudo clínico randomizado","authors":"Edmundo Pereira de Souza Neto , Gorka Usandizaga","doi":"10.1016/j.bjan.2020.03.015","DOIUrl":"10.1016/j.bjan.2020.03.015","url":null,"abstract":"<div><h3>Introduction</h3><p>Tranexamic Acid (TXA), an antifibrinolytic that inhibits the fibrinolytic activity of plasmin is used to decrease perioperative blood loss and transfusion requirements in orthopedic surgery. The aim of our study was to compare postoperative bleeding in two intra‐articular doses (1<!--> <!-->g and 2<!--> <!-->g) of tranexamic acid in adult patients undergoing unilateral total knee replacement.</p></div><div><h3>Method</h3><p>We conducted a single‐operator, randomized, and controlled, double‐blind study in two groups. The G1 group received 1<!--> <!-->g of intra‐articular TXA and the G2 group 2<!--> <!-->g of intra‐articular TXA. Both groups received 15<!--> <!-->mg.kg<sup>‐1</sup> IV before the surgical incision (TXA induction dose) and then 10<!--> <!-->mg.kg<sup>‐1</sup>, orally, 6 and 12<!--> <!-->hours after the induction dose of TXA. The primary endpoint was bleeding measured by blood loss in postoperative drainage. Secondary outcomes were change in hemoglobin and hematocrit levels on the first and third postoperative days, and the need for transfusion during hospitalization.</p></div><div><h3>Results</h3><p>In total, 100 patients were randomized, and 100 were included in the analysis. Blood loss in postoperative drainage was similar in both groups (200<!--> <!-->±<!--> <!-->50 vs. 250<!--> <!-->±<!--> <!-->50<!--> <!-->mL, G1 and G2 groups respectively). Change in hematocrit and hemoglobin values (% of change) between preoperative and day 3 were not statically significant between groups G1 and G2 (18<!--> <!-->±<!--> <!-->5 vs. 21<!--> <!-->±<!--> <!-->4; 21<!--> <!-->±<!--> <!-->7 vs. 22<!--> <!-->±<!--> <!-->5 respectively). No patients received blood transfusion.</p></div><div><h3>Conclusions</h3><p>Our study did not show superiority of 2<!--> <!-->g of intra‐articular tranexamic acid compared to 1<!--> <!-->g.</p><p>ClinicalTrials.gov Identifier NCT04085575</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 318-324"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.03.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38285179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Filipe Valério de Lima , Júlia Gonçalves Zandomenico , Matheus Nilton Bernardi do Prado , Darlan Favreto
{"title":"Bloqueio do plano eretor da espinha em cirurgia ortopédica pediátrica: dois relatos de caso","authors":"Filipe Valério de Lima , Júlia Gonçalves Zandomenico , Matheus Nilton Bernardi do Prado , Darlan Favreto","doi":"10.1016/j.bjan.2020.04.008","DOIUrl":"10.1016/j.bjan.2020.04.008","url":null,"abstract":"<div><p>The erector spinae plane block is a safe and effective regional anesthesia technique, which has earned new indications perioperatively since its description. We introduce two pediatric anesthesia cases in which we performed the erector spinae plane block during intermediate/major orthopedic surgeries. The first patient is a 2 year‐old girl submitted to surgical treatment of developmental dysplasia of the hip. The second patient is a 14 year‐old boy submitted to surgical treatment of bilateral clubfoot. This last patient is potentially the first published case in which the erector spinae plane block was performed for ankle and foot surgery. Both cases experienced excellent analgesia, avoiding opiate requirement completely.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 440-442"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38303731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tailyne Zortéa , Daniele Paola da Silva Wizbicki , Kristian Madeira , Pedro Gabriel Ambrosio , Rafaela Okchstein Borges de Souza , Edson Souza Machado Durães
{"title":"Monitorização não invasiva da hemoglobina em ensaios clínicos: uma revisão sistemática e metanálise","authors":"Tailyne Zortéa , Daniele Paola da Silva Wizbicki , Kristian Madeira , Pedro Gabriel Ambrosio , Rafaela Okchstein Borges de Souza , Edson Souza Machado Durães","doi":"10.1016/j.bjan.2019.05.006","DOIUrl":"10.1016/j.bjan.2019.05.006","url":null,"abstract":"<div><h3>Background and objectives</h3><p>The measurement of Hb by co‐oximetry is an innovative technique that offers efficiency and agility in the processing of information regarding the measurement of Hemoglobin concentration (Hb) obtained through continuous, non‐invasive and rapid monitoring. Because of this attribute, it avoids unnecessary exposures of the patient to invasive procedures by allowing a reduction in the number of blood samples for evaluation and other unnecessary therapies. It also helps to make decisions about the need for transfusion and how to handle it. The objective of this study is to compare the performance offered to obtain Hb values between the Masimo Corporation (Irvine, CA, USA) instrument and the standard gold tool (laboratory examination).</p></div><div><h3>Contents</h3><p>The study corresponds to a systematic review followed by meta‐analysis, which included fully registered full‐text clinical trials published from 1990 to 2018. PubMed, Cochrane, Medline, Embase and Web of Science databases were investigated. The mean overall difference found between the non‐invasive and invasive methods of hemoglobin monitoring was 0.23 (95% CI ‐0.16, 0.62), that is, it did not present statistical significance (<em>p</em> <!--> <!-->=<!--> <!--> 0.250). The results of the analysis of heterogeneity within and between the studies indicated high levels of inconsistency (Q <!--> <!-->=<!--> <!--> 461.63, <em>p</em> <!--> <!--><<!--> <!--> 0.0001, I<sup>2</sup> <!--> <!-->=<!--> <!--> 98%), method for Hb values.</p></div><div><h3>Conclusions</h3><p>Although the mean difference between noninvasive measurements of Hb and the gold standard method is small, the co‐oximeter can be used as a non‐invasive “trend” monitor in detecting unexpected responses at Hb levels.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 388-397"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2019.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38174544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abordagem supina axilar média coronal para realização de bloqueio do quadrado lombar anterior: relato de casos","authors":"Sandeep Diwan , Rafael Blanco , Medha Kulkarni , Atul Patil , Abhijit Nair","doi":"10.1016/j.bjan.2020.04.007","DOIUrl":"10.1016/j.bjan.2020.04.007","url":null,"abstract":"<div><h3>Background</h3><p>There are various approaches to perform an ultrasound guided Quadratus Lumborum Block (QLB). The lateral, posterior, anterior or trans muscular and subcostal paramedian are the various approaches described for performing a QLB. Each of these blocks are aimed to achieve a maximum spread with high volume and low concentration of local anesthetics.</p></div><div><h3>Case report</h3><p>In this novel approach a curvilinear ultrasound probe was used with the patient lying in supine position. The probe was placed longitudinally in the mid axillary line to visualize Quadratus Lumborum Muscle (QLM) in the coronal plane. The needle was then introduced from cranial to caudal direction and catheters were inserted in the Anterior Thoracolumbar Fascia (ATLF) up to a distance of 4−5 cm in 24 patients for an anterior approach to acetabulum fractures. The needle tip and the Local Anesthetic (LA) spread was visible in all patients. All patients except 4 had excellent perioperative pain relief considering stable hemodynamics and VAS 2−3/10 for the first 48 hours. All patients received 1<!--> <!-->g intravenous paracetamol each 8<!--> <!-->hours. VAS in postoperative period was 2−3/10, in 20/24 patients. In the postoperative period, 4 patients complained of persistent pain, requiring intravenous fentanyl boluses and multimodal analgesia. Mean VAS score was 2.87 from 0−12 hours, 3.14 from 12−24 hours, and 3.35 from 24−48 hours. There were no block‐related complications in any patient.</p></div><div><h3>Conclusion</h3><p>The supine midaxillary coronal approach to anterior QLB is an effective and feasible approach to QLB which can be performed in supine position.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 443-447"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38216349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impacto da hipotensão e perda sanguínea intraoperatórias na lesão renal aguda após cirurgia de pâncreas","authors":"Mitsuru Ida, Mariko Sumida, Yusuke Naito, Yuka Tachiiri, Masahiko Kawaguchi","doi":"10.1016/j.bjan.2020.04.011","DOIUrl":"10.1016/j.bjan.2020.04.011","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate factors associated with postoperative Acute Kidney Injury (AKI) focusing on intraoperative hypotension and blood loss volume.</p></div><div><h3>Methods</h3><p>This was a retrospective cohort study of patients undergoing pancreas surgery between January 2013 and December 2018. The primary outcome was AKI within 7 days after surgery and the secondary outcome was the length of hospital stay. Multivariate analysis was used to determine explanatory factors associated with AKI; the interaction between the integrated value of hypotension and blood loss volume was evaluated. The differences in length of hospital stay were compared using the Mann‐Whitney <em>U</em>‐test.</p></div><div><h3>Results</h3><p>Of 274 patients, 22 patients had experienced AKI. The cube root of the area under intraoperative mean arterial pressure of < 65 mmHg (Odds Ratio = 1.21; 95% Confidence Interval 1.01–1.45; <em>p</em> = 0.038) and blood loss volume of > 500 mL (Odds Ratio = 3.81; 95% Confidence Interval 1.51–9.58; <em>p</em> = 0.005) were independently associated with acute kidney injury. The interaction between mean arterial hypotension and the blood loss volume in relation to acute kidney injury indicated that the model was significant (<em>p</em> < 0.0001) with an interaction effect (<em>p</em> = 0.0003). AKI was not significantly related with the length of hospital stay (19 vs. 28 days, <em>p</em> = 0.09).</p></div><div><h3>Conclusion</h3><p>The area under intraoperative hypotension and blood loss volume of > 500 mL was associated with postoperative AKI. However, if the mean arterial pressure is maintained even in patients with large blood loss volume, the risk of developing postoperative AKI is comparable with that in patients with small blood loss volume.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 343-348"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38216350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bloqueio do nervo articular e cutâneo no cotovelo: relato de dois casos","authors":"Sandeep Diwan , Abhijit Nair","doi":"10.1016/j.bjan.2020.03.014","DOIUrl":"10.1016/j.bjan.2020.03.014","url":null,"abstract":"<div><h3>Background and objectives</h3><p>In patients with elbow fractures, when there is suspected injury to underlying nerves, it is imperative for surgeons to elicit the function in the immediate postoperative period. Brachial plexus blocks like interscalene, supraclavicular and infraclavicular approaches can be a hurdle in such situations. The block planned should allow assessment of integrity of the nerves immediately in the postoperative period.</p></div><div><h3>Case report</h3><p>We describe two cases in which we administered a block not yet described in literature. We blocked the cutaneous and articular branches innervating the elbow under ultrasound guidance. General anesthesia was administered in both cases. The block provided stable intraoperative hemodynamics, good postoperative analgesia and also allowed surgeons to test the viability of the nerve.</p></div><div><h3>Conclusion</h3><p>In situations where nerves are injured during elbow fractures, selective articular cutaneous block at elbow can be used as it provides good perioperative analgesia, besides allowing evaluation of motor and sensory components in the postoperative period.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 429-433"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.03.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38216347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savas Altinsoy, Ceyda Ozhan Caparlar, Jülide Ergil
{"title":"Relação entre ansiedade pré‐operatória e consciência durante a anestesia: estudo observacional","authors":"Savas Altinsoy, Ceyda Ozhan Caparlar, Jülide Ergil","doi":"10.1016/j.bjan.2020.04.012","DOIUrl":"10.1016/j.bjan.2020.04.012","url":null,"abstract":"<div><h3>Background</h3><p>Anxiety is a state of worry caused by the anticipation of external or internal danger. Awareness During Anesthesia (ADA) is an unexpected memory recall during anesthesia. In this study, we aimed to determine the factors that affect preoperative anxiety and observe the incidence of ADA, as well as to determine the anxiety levels of these patients with a history of ADA.</p></div><div><h3>Methods</h3><p>This study was planned to be prospective, observational, and cross‐sectional. Patients in whom septoplasty was planned, who was admitted to the anesthesiology outpatients between March 2018 and September 2018, were ASA I−II, and aged 18−70 years were included in the study. The demographic characteristics of patients were recorded. The State‐Trait Anxiety Inventory (STAI) was used to determine anxiety during a preoperative evaluation. The modified Brice awareness score was used simultaneously to determine previous ADA.</p></div><div><h3>Results</h3><p>The anxiety scores of patients who were conscious during anesthesia were higher than other patients. The mean STAI score was 40.85±14.8 in the 799 patients who met the inclusion criteria of this study. When the anxiety scores were compared, the scores were higher in females than in males (<em>p</em> < 0.05). The mean STAI score was found as 40.3±13.8 in patients who dreamed during anesthesia.</p></div><div><h3>Conclusion</h3><p>It is important to determine the anxiety levels of patients in the preoperative period to prevent the associated complications. Preoperative anxiety, besides preventing ADA, should be dealt with in a multidisciplinary manner. ADA should be carefully questioned while evaluating previous anesthesia experiences.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 349-356"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38270142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felipe Chiodini Machado, Gilson Carone Neto, Luisa Oliveira de Paiva, Tamiris Cristina Soares, Ricardo Kenithi Nakamura, Leonardo de Freitas Nascimento, Camila Sato Campana, Lia Alves Martins Mota Lustosa, Rachel Andrade Cortez, Hazem Adel Ashmawi
{"title":"Uso da buprenorfina transdérmica na dor aguda pós‐operatória: revisão sistemática","authors":"Felipe Chiodini Machado, Gilson Carone Neto, Luisa Oliveira de Paiva, Tamiris Cristina Soares, Ricardo Kenithi Nakamura, Leonardo de Freitas Nascimento, Camila Sato Campana, Lia Alves Martins Mota Lustosa, Rachel Andrade Cortez, Hazem Adel Ashmawi","doi":"10.1016/j.bjan.2020.04.004","DOIUrl":"10.1016/j.bjan.2020.04.004","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Postoperative pain is still a major concern in several surgical procedures. Multimodal analgesia is best for postoperative pain management; however, opioid therapy is still the main treatment for pain after surgical procedures. Transdermal buprenorphine is a partial μ agonist opioid widely used for chronic pain syndromes, with limited evidence for acute postoperative pain. A systematic review of studies examining transdermal buprenorphine for acute pain management after surgery was conducted.</p></div><div><h3>Contents</h3><p>Data from PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL via EBSCOhost, and LILACS were reviewed, including randomized clinical trials that evaluated total postoperative pain, postoperative analgesic consumption, drug‐related side effects and patient satisfaction with analgesia regimen. Data from nine studies (615 patients) were included in this review. Most studies initiated transdermal buprenorphine use 6 to 48 hours before surgery, maintaining use from 1 to 8 days after the procedure. Most studies showed lower or similar postoperative pain scores, postoperative analgesic consumption and patient satisfaction comparing buprenorphine to placebo, tramadol, celecoxib, flurbiprofen and parecoxib. The incidence of side effects varied between studies, with most showing no increase in drug‐related side effects with buprenorphine use, except one study, which compared buprenorphine to oral tramadol, and one to transdermal fentanyl. However, most results were derived from evidence with an overall high or unclear risk of bias.</p></div><div><h3>Conclusions</h3><p>Although more studies are necessary, initial results show that transdermal buprenorphine seems to be an effective and safe opioid choice for management of acute postoperative pain.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 4","pages":"Pages 419-428"},"PeriodicalIF":1.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2020.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38285180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sérgio Timerman, Hélio Penna Guimarães, Roseny Dos Reis Rodrigues, Thiago Domingos Corrêa, Daniel Ujakow Correa Schubert, Ana Paula Freitas, Álvaro Rea Neto, Thatiane Facholi Polastri, Matheus Fachini Vane, Thomaz Bittencourt Couto, Antonio Carlos Aguiar Brandão, Natali Schiavo Giannetti, Maria José Carvalho Carmona, Thiago Timerman, Ludhmila Abrahão Hajjar, Fernando Bacal, Marcelo Queiroga
{"title":"WITHDRAWN: Recomendações para Ressuscitação Cardiopulmonar (RCP) de pacientes com diagnóstico ou suspeitos de COVID-19.","authors":"Sérgio Timerman, Hélio Penna Guimarães, Roseny Dos Reis Rodrigues, Thiago Domingos Corrêa, Daniel Ujakow Correa Schubert, Ana Paula Freitas, Álvaro Rea Neto, Thatiane Facholi Polastri, Matheus Fachini Vane, Thomaz Bittencourt Couto, Antonio Carlos Aguiar Brandão, Natali Schiavo Giannetti, Maria José Carvalho Carmona, Thiago Timerman, Ludhmila Abrahão Hajjar, Fernando Bacal, Marcelo Queiroga","doi":"10.1016/j.bjan.2020.06.002","DOIUrl":"10.1016/j.bjan.2020.06.002","url":null,"abstract":"","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39083294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alparslan Kuş , Ufuk H. Yörükoğlu , Can Aksu , Saffet Çınar , Nuh Zafer Cantürk , Yavuz Gürkan
{"title":"Efeito do bloqueio paravertebral torácico na redução de seroma em cirurgia de mama – estudo randomizado controlado","authors":"Alparslan Kuş , Ufuk H. Yörükoğlu , Can Aksu , Saffet Çınar , Nuh Zafer Cantürk , Yavuz Gürkan","doi":"10.1016/j.bjan.2019.12.015","DOIUrl":"https://doi.org/10.1016/j.bjan.2019.12.015","url":null,"abstract":"<div><h3>Background</h3><p>Increasing number of patients are being operated because of breast cancer. Seroma is the most common problem that occurs after surgery that increases morbidity. For postoperative pain management, Thoracic Paravertebral Block (TPVB) has long been considered the gold standard technique. With performing TPVB, sympathetic nerves are also blocked.</p></div><div><h3>Objective</h3><p>With this study, we aimed to search the effect of TPVB on seroma reduction in patients who undergo mastectomy and axillary node dissection surgery.</p></div><div><h3>Methods</h3><p>Forty ASA I<span>–</span>II female patients aged 18<span>–</span>65, who were scheduled to go under elective unilateral mastectomy and axillary lymph node resection were included to the study. Patients were randomized into two groups as TPVB and control group. Ultrasound guided TPVB with 20 mL 0.25% bupivacaine was performed at T1 level preoperatively to the TPVB group patients. All patients were provided with i.v. patient‐controlled analgesia device. Seroma formation amounts, morphine consumptions and Numeric Rating Scale (NRS) scores for pain were recorded 24<sup>th</sup> hour postoperatively.</p></div><div><h3>Results and conclusions</h3><p>Mean seroma formation at postoperative 24<sup>th</sup> hour was 112.5<!--> <!-->±<!--> <!-->53.3 mL in the control group and 74.5<!--> <!-->±<!--> <!-->47.4 mL in the TPVB group (<em>p<!--> </em>=<!--> <!-->0.022). NRS scores were similar between two groups (<em>p</em> <!-->=<!--> <!-->0.367) at postoperative 24<sup>th</sup> hour but mean morphine consumption at postoperative 24<sup>th</sup> hour was 5.6<!--> <!-->±<!--> <!-->4 mg in the TPBV group, and 16.6<!--> <!-->±<!--> <!-->6.9 mg in the control group (<em>p</em> <<!--> <!-->0.001). TPVB reduces the amount of seroma formation while providing effective analgesia in patients who undergo mastectomy and axillary lymph node removal surgery.</p></div>","PeriodicalId":21261,"journal":{"name":"Revista brasileira de anestesiologia","volume":"70 3","pages":"Pages 215-219"},"PeriodicalIF":1.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.bjan.2019.12.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72264606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}