scholarly journals Maintenance anaesthetics during remifentanil-based anaesthesia might affect postoperative pain control after breast cancer surgery ‡ ‡This article is accompanied by the Editorial.

2010 ◽  
Vol 105 (5) ◽  
pp. 661-667 ◽  
Author(s):  
S.-W. Shin ◽  
A.-R. Cho ◽  
H.-J. Lee ◽  
H.-J. Kim ◽  
G.J. Byeon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Pain Control ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Postoperative Pain Control

scholarly journals Right Breast Mastectomy and Reconstruction with Tissue Expander under Thoracic Paravertebral Blocks in a 12-Week Parturient

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Christopher Allen-John Webb ◽  
Paul David Weyker ◽  
Shara Cohn ◽  
Amanda Wheeler ◽  
Jennifer Lee
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Pain Control ◽  
Breast Surgery ◽  
Anesthetic Management ◽  
Healthy Woman ◽  
Tissue Expander ◽  
Postoperative Pain Control ◽  
Tissue Expanders

Paravertebral blocks are becoming increasingly utilized for breast surgery with studies showing improved postoperative pain control, decreased need for opioids, and less nausea and vomiting. We describe the anesthetic management of an otherwise healthy woman who was 12 weeks pregnant presenting for treatment of her breast cancer. For patients undergoing breast mastectomy and reconstruction with tissue expanders, paravertebral blocks offer an anesthetic alternative when general anesthesia is not desired.

Postoperative oxycodone in breast cancer surgery: What factors associate with analgesic plasma concentrations?

2016 ◽  
Vol 12 (1) ◽  
pp. 118-119
Author(s):  
Kristiina Cajanus ◽  
Mikko Neuvonen ◽  
Mari Kaunisto ◽  
Outi Koskela ◽  
Pertti J. Neuvonen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Demographic Data ◽  
Geometric Mean ◽  
Plasma Concentrations ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Satisfactory Analgesia ◽  
Type Of Surgery

AbstractAimsParenteral oxycodone is increasingly used worldwide to manage perioperative pain. Oxycodone doses required for adequate analgesia vary significantly between individuals. Our study investigated whether an analgesic plasma concentration could be determined for oxycodone and which factors affect it.Methods1000 women undergoing breast cancer surgery were recruited to the study. Demographic data were collected and their cold and heat pain sensitivity and anxiety scores were measured preoperatively. After surgery, rest and motion pain intensities were measured. Intravenous oxycodone was administered until the patients reported satisfactory pain relief (NRS <4/10). At this point, plasma concentrations of oxycodone and its metabolites were determined. A second plasma sample for oxycodone deter-mination was taken when the patient requested a new dose of oxycodone. Genomic DNA was extracted from whole blood samples and the patients were genotyped for CYP2D6, CYP3A4 and CYP3A5 variants.ResultsThe two oxycodone concentrations showed a strong correlation (r =0.84). The pain intensity measured during motion before oxycodone dosing correlated significantly with the plasma oxycodone concentration (geometric mean 35.3 ng/ml and CV % 66.4) required to achieve satisfactory analgesia (r = 0.38, p = 1.5 x 10-33). The most important factors associating with postoperative pain intensity were type of surgery (breast conserving or mastectomy with or without axillary clearance) and the age of the patient. Older patients reported lower pain scores and required smaller oxycodone concentrations for satisfactory analgesia. CYP2D6, CYP3A5 or CYP3A4 genotypes did not significantly affect the oxycodone concentrations, but CYP2D6 genotype significantly affected the formation of the metabolites oxymorphone and noroxymorphone. CYP3A4 and CYP3A5 genotypes did not affect the metabolite formation.ConclusionsOur results indicate that the more pain the patient experiences postoperatively the greater her minimum plasma oxycodone concentration must be to achieve satisfactory analgesia. Type of surgery and age significantly affect postoperative pain intensity.

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