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suck abstract from ncbi

pmid33620809      StatPearls-/-ä 2024 ; ä (ä): ä
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  • Regional Anesthesia for Breast Reconstruction #MMPMID33620809
  • Ben Aziz M; Hendrix JM; Mukhdomi T
  • StatPearls-/-ä 2024[Jan]; ä (ä): ä PMID33620809show ga
  • Breast cancer is the most common cancer in women around the world. It is presented as the second cause of cancer deaths after lung cancer. The incidence of this aggressive disease, with around 17,000,000 new cases each year, becomes worrying and alarming. The risk of dying from breast cancer increases by 5% for every one-year reduction in age at diagnosis, indicating the presence of more aggressive phenotypes than breast cancers occurring later in life. According to US breast cancer statistics, 42,170 women in the US were expected to die of breast cancer in 2020. Cancer mortality is not related to the primary tumor but often to recurrence or general metastasis. Surgery remains the main modality for managing resectable breast cancer because it is important in controlling locally advanced or metastatic disease. After a mastectomy, reconstruction should be offered to all breast cancer patients. These are the recommendations of the National Institute for Health and Clinical Excellence (NICE), but the type of reconstruction used is currently at the surgeon's and patient's discretion. About 10% to 20% of patients experience acute postoperative pain, which may progress to chronicity, known as postmastectomy pain syndrome. The improvement of anesthesia factors has a positive significance for promoting the rehabilitation of patients. Effective pain management is crucial in enhanced recovery after surgery; thus, proper follow-up with a pain physician could benefit those presenting with postmastectomy pain syndrome. Several recent studies have shown decreased postoperative pain when regional anesthesia techniques are combined with general anesthesia during breast reconstruction surgery. These studies suggest that locoregional anesthesia is involved in controlling acute postoperative pain, reducing opioid consumption, leading to early revalidation, and reducing patient length of stay. This article will describe the main techniques of locoregional anesthesia involved in breast reconstruction surgery. These are paravertebral block, intercostal nerve block, erector spinae plane block (EPSB), pectoralis nerve block (Pecs), and serratus anterior plane blocks.
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