論文

査読有り
2016年4月

Comparison of general anesthesia and monitored anesthesia care in patients undergoing breast cancer surgery using a combination of ultrasound-guided thoracic paravertebral block and local infiltration anesthesia: a retrospective study

JOURNAL OF ANESTHESIA
  • Masami Sato
  • ,
  • Gotaro Shirakami
  • ,
  • Kazuhiko Fukuda

30
2
開始ページ
244
終了ページ
251
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00540-015-2111-z
出版者・発行元
SPRINGER JAPAN KK

The aim of this study was to compare post-anesthesia recovery time and the incidence of hypotension episodes during anesthesia in breast cancer surgery between general anesthesia (GA) and monitored anesthesia care (MAC) retrospectively. Both techniques were combined with ultrasound-guided paravertebral block (US-PVB) and local infiltration anesthesia (LIA).
We reviewed the medical records of patients who received US-PVB for breast cancer surgery retrospectively and divided them into two groups based on the method of anesthetic management. In the GA group, anesthesia was induced using propofol and maintained by sevoflurane inhalation via a laryngeal mask airway after US-PVB was performed under sedation with midazolam. In the MAC group, US-PVB and surgery were carried out under sedation with propofol and remifentanil and supplemental oxygen through a facemask. All patients in both groups breathed spontaneously and received US-PVB and LIA with 0.5 % ropivacaine and diclofenac suppository for pain relief.
Times from post-anesthesia care unit admission to fluid intake (mean +/- SD; 79 +/- A 34 vs. 99 +/- A 33 min, P = 0.034) and gait (77 +/- A 45 vs. 109 +/- A 45 min, P = 0.013) were significantly shorter in the MAC group (n = 29) than in the GA group (n = 29). Average systolic blood pressure (SBP) was significantly lower (89 +/- A 11 vs. 99 +/- A 16 mmHg, P = 0.011) and the incidence of hypotension (SBP < 70 mmHg) was higher (52 vs. 21 %, P = 0.014) in the GA group than in the MAC group during anesthesia.
MAC with US-PVB and LIA exhibited faster post-anesthesia recovery and a lower incidence of hypotension episodes during anesthesia than GA with US-PVB and LIA in breast cancer surgery.

Web of Science ® 被引用回数 : 10

リンク情報
DOI
https://doi.org/10.1007/s00540-015-2111-z
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26661141
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000373300600010&DestApp=WOS_CPL

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