Our Summary

This research study looked at whether ultrasound-guided erector spinae block (ESB) is as effective as thoracic epidural (TE) in managing pain after breast cancer surgery. The study involved 42 patients who were split into two equal groups. The main outcomes they looked at were the amount of fentanyl (a type of pain medication) used during surgery, pain levels after surgery, and the need for extra pain relief. They also took into account changes in heart rate and blood pressure during surgery and the number of patients who felt sick or vomited after the operation. The results showed no significant difference between the two groups in terms of pain levels and the amount of fentanyl used. No patients in either group needed extra pain relief. However, fewer patients who received the erector spinae block felt sick or vomited two hours after surgery. There were also no significant differences in heart rate and blood pressure changes during surgery between the two groups. The study concluded that the erector spinae block is as effective in relieving pain as the thoracic epidural during and after breast cancer surgery. Given that erector spinae block has a lower risk of complications, the study suggested it could be a promising alternative for managing pain after this type of surgery.

FAQs

  1. What was the main focus of the research study on ultrasound-guided erector spinae block (ESB) and thoracic epidural (TE)?
  2. What were the main outcomes and results of the study comparing ESB and TE in managing pain after breast cancer surgery?
  3. Based on the study, how does the erector spinae block compare in effectiveness to the thoracic epidural in relieving pain during and after breast cancer surgery?

Doctor’s Tip

A doctor might advise a patient undergoing a radical mastectomy to discuss the option of an ultrasound-guided erector spinae block (ESB) with their healthcare provider as a potential alternative for pain management during and after surgery. This method has been shown to be as effective as a thoracic epidural (TE) in relieving pain, with the added benefit of fewer side effects such as nausea and vomiting. It is important to have an open and informed discussion with your healthcare team to determine the best pain management strategy for your individual needs and preferences.

Suitable For

Patients who are typically recommended radical mastectomy include those with large or locally advanced breast cancers, inflammatory breast cancer, or those with a high risk of recurrence. Additionally, patients with certain genetic mutations, such as BRCA1 or BRCA2, may also be recommended for this type of surgery. Radical mastectomy involves the removal of the entire breast, underlying chest muscles, and lymph nodes in the armpit, and is often considered when less invasive surgical options are not sufficient to treat the cancer.

Timeline

Before radical mastectomy:

  1. Diagnosis of breast cancer and discussion of treatment options with healthcare provider.
  2. Decision to undergo radical mastectomy as the chosen treatment option.
  3. Pre-operative consultations and tests to assess overall health and plan for surgery.
  4. Pre-operative preparations such as fasting, medications, and anesthesia discussion.
  5. Surgical procedure to remove the breast tissue and surrounding lymph nodes.

After radical mastectomy:

  1. Immediate recovery in the hospital with monitoring of vital signs and pain management.
  2. Post-operative care including wound care, physical therapy, and monitoring for complications.
  3. Pain management with medications and interventions such as ultrasound-guided erector spinae block or thoracic epidural.
  4. Follow-up appointments with healthcare provider to monitor healing progress and discuss further treatment options.
  5. Emotional support and counseling to cope with body image changes and recovery process.

What to Ask Your Doctor

  1. What is a radical mastectomy and why is it recommended for me?
  2. What are the potential risks and complications associated with a radical mastectomy?
  3. How long is the recovery period after a radical mastectomy?
  4. Will I need additional treatments such as chemotherapy or radiation therapy after the surgery?
  5. What are my options for breast reconstruction surgery after a radical mastectomy?
  6. How will a radical mastectomy affect my daily activities and quality of life?
  7. Are there any specific exercises or precautions I should take during the recovery period?
  8. What support resources are available for patients undergoing a radical mastectomy?
  9. How often will I need follow-up appointments after the surgery?
  10. Are there any alternative treatments or procedures that I should consider before undergoing a radical mastectomy?

Reference

Authors: R D, Parameswari A, Venkitaraman B, Vakamudi M, Manickam A. Journal: Cureus. 2023 Dec 26;15(12):e51103. doi: 10.7759/cureus.51103. eCollection 2023 Dec. PMID: 38149062