Analgesia Clinical Trial
Official title:
Efficacy of Ultrasound-guided Transversus Abdominis Plane Block in Breast Reconstruction Surgery With Abdominal Myocutaneous Flap: an Observational Prospective Study
Ultrasound (US)-guided transversus abdominis plane block (TAP) has demonstrated favourable
results in lower abdominal surgery. Literature about its efficacy in breast reconstruction
surgery with transversus rectus abdominis myocutaneous (TRAM) flap is still scarce.
In the current study investigators pretend to evaluate the efficacy of US-guided bilateral
TAP block for unilateral breast reconstruction using autologous abdominal graft in women with
breast cancer's history.
The investigators led a prospective observational study in patients/participants scheduled to
unilateral breast reconstruction surgery with TRAM flap (UBR TRAM) or partial/total or
totalization mastectomy followed by TRAM reconstruction (M + UBR TRAM). Participants'
anesthetic plan was general balanced anesthesia (GBA) or general balanced anesthesia combined
with bilateral TAP block (GBA + TAP).
The anesthetic plan was adopted by the anaesthetist assigned to the operating room on
surgery's day. Then, two groups were considered for the study: group submitted to GBA and
another submitted to GBA + TAP. Anaesthetic information about intra-operative date was
consulted. Investigators included patients subjected to general anesthesia with orotracheal
intubation. Intravenous (IV) bolus of fentanyl were administered at anesthetic induction and
according to analgesic needs. In patients whose anesthetic plan included TAP block
investigators considered cases that it was performed after anesthetic induction before
surgical incision. TAP block was performed according to Anesthesiology's Department. After
aspiration, a volume of 20 mL ropivacaine 0.375% was administered, bilaterally. Investigators
didn´t consider for the study participants whose systemic postoperative analgesic protocol
wasn't that adopted by Anesthesiology Department for this kind of surgery.
It was evaluated:
- Intraoperative period: fentanyl consumption (mg/kg), antiemetic prophylaxis and
anesthesia duration;
- Post-anaesthesia care unit (PACU): consumed opioids, total score and score relative to
consciousness, at admission and discharge, pain assessment, at admission and discharge
and nausea and vomiting incidence and stay's length
- After discharge of PACU until 4 hours after surgery's end and between 4th until 24th
postoperative hour: morphine consumption, pain assessment, nausea and vomiting incidence
and other complications.
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