Our Summary

This study compared two types of anesthesia: total intravenous anesthesia (TIVA), which is given through an injection, and inhalational anesthesia, which is breathed in by the patient. The researchers wanted to see which method was better in terms of depth of anesthesia, recovery time, and effects on the patient’s blood flow and heart rate during a specific type of breast cancer surgery called a modified radical mastectomy.

The study involved 100 patients who were split into two groups. One group was given TIVA using two drugs, propofol and dexmedetomidine. The other group was given inhalational anesthesia using a gas called sevoflurane.

The results showed that both methods were equally effective at achieving the right level of anesthesia and maintaining stable heart rate and blood pressure during surgery. However, patients who received TIVA woke up from anesthesia about 3 minutes faster than those who received inhalational anesthesia. The cost of the drugs used for TIVA was also 40% less than the cost of the gas used for inhalational anesthesia.

In conclusion, the study suggests that TIVA could be a more cost-effective and eco-friendly option for this type of surgery, without compromising on the quality of anesthesia.

FAQs

  1. What types of anesthesia were compared in this study on breast cancer surgery?
  2. What were the key findings of the study comparing TIVA and inhalational anesthesia?
  3. Is TIVA more cost-effective than inhalational anesthesia in performing a modified radical mastectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about radical mastectomy is to discuss with them the different options for anesthesia and the potential benefits of using total intravenous anesthesia (TIVA) over inhalational anesthesia. TIVA may result in a faster recovery time and lower cost, while still providing effective anesthesia during surgery. It is important for patients to be informed about their options and to work with their healthcare team to determine the best approach for their individual needs.

Suitable For

Typically, patients who are recommended radical mastectomy are those with larger or more aggressive breast tumors, or those with a higher risk of breast cancer recurrence. These patients may benefit from the more extensive surgery to remove as much of the breast tissue as possible to reduce the risk of cancer spreading or reoccurring.

Timeline

Before the radical mastectomy:

  • Patient undergoes pre-operative assessments, including physical exams, blood tests, and imaging studies
  • Patient meets with the surgical team to discuss the procedure, risks, and recovery process
  • Patient may undergo additional tests, such as a biopsy, to confirm the diagnosis of breast cancer
  • Patient may undergo neoadjuvant therapy, such as chemotherapy or radiation, to shrink the tumor before surgery

After the radical mastectomy:

  • Patient wakes up in the recovery room after surgery
  • Patient may experience pain and discomfort at the surgical site
  • Patient is closely monitored for any post-operative complications, such as infection or bleeding
  • Patient may need to stay in the hospital for a few days for observation and pain management
  • Patient receives instructions on wound care, physical activity restrictions, and follow-up appointments
  • Patient may undergo reconstructive surgery or receive post-operative treatments, such as chemotherapy or radiation, depending on the stage and type of breast cancer.

What to Ask Your Doctor

  1. What are the potential risks and benefits of undergoing a radical mastectomy?
  2. Why is a radical mastectomy being recommended for me specifically?
  3. What are the expected outcomes and recovery time following a radical mastectomy?
  4. Are there any alternative treatment options to consider?
  5. What is the experience of the surgical team in performing radical mastectomies?
  6. What type of anesthesia will be used during the surgery and why?
  7. What are the potential side effects or complications associated with the anesthesia chosen for the surgery?
  8. How will pain management be handled during and after the surgery?
  9. How long will I need to stay in the hospital following the surgery?
  10. What post-operative care and follow-up appointments will be necessary after the radical mastectomy?

Reference

Authors: Goel N, Jha R, Bhardwaj M, Chawla R. Journal: Anesth Essays Res. 2020 Jul-Sep;14(3):420-424. doi: 10.4103/aer.AER_13_21. Epub 2021 Mar 22. PMID: 34092852