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Ambulatory surgical management of breast carcinoma using paravertebral block.

Publication ,  Journal Article
Weltz, CR; Greengrass, RA; Lyerly, HK
Published in: Ann Surg
July 1995

OBJECTIVE: The authors describe an initial experience using paravertebral block for ambulatory or short-stay operations for breast cancer. BACKGROUND: Rising hospital costs have focused attention on limiting the length of stay for patients undergoing surgical treatment of breast cancer. Thus far, ambulatory surgery has been limited by side effects and complications of general anesthesia. Paravertebral block offers the potential benefit of effective analgesia, with limited postoperative nausea and vomiting. METHODS: The medical records of the first 15 patients with breast cancer who underwent 16 major operations for the treatment of breast cancer using paravertebral block were reviewed. Patients were either discharged directly from the recovery room or after overnight hospital admission. The effectiveness of anesthesia, surgical outcome, patient satisfaction, and hospital costs are reviewed. RESULTS: Paravertebral block achieved effective anesthesia for cancer operations of the breast and axilla; conversion to general anesthesia or supplementation with local anesthesia was not required. There was one postoperative hemorrhage, there were two seromas, and there was one superficial wound infection. Sensory block persisted for an average of 23 hours. Postoperative pain was effectively controlled, in fact, nine patients required no postoperative narcotic for pain control. Nausea and vomiting transiently afflicted three patients and prompted overnight observation in one patient originally scheduled for immediate discharge. Fourteen patients (93%) rated their experience as "very satisfactory." CONCLUSION: Breast operations for the surgical management of breast cancer using paravertebral block can be performed safely, with great patient satisfaction, and with potential for significant cost savings.

Duke Scholars

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

July 1995

Volume

222

Issue

1

Start / End Page

19 / 26

Location

United States

Related Subject Headings

  • Time Factors
  • Surgery
  • Patient Satisfaction
  • Nerve Block
  • Middle Aged
  • Humans
  • Female
  • Breast Neoplasms
  • Anesthesia, Spinal
  • Ambulatory Surgical Procedures
 

Citation

APA
Chicago
ICMJE
MLA
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Weltz, C. R., Greengrass, R. A., & Lyerly, H. K. (1995). Ambulatory surgical management of breast carcinoma using paravertebral block. Ann Surg, 222(1), 19–26. https://doi.org/10.1097/00000658-199507000-00004
Weltz, C. R., R. A. Greengrass, and H. K. Lyerly. “Ambulatory surgical management of breast carcinoma using paravertebral block.Ann Surg 222, no. 1 (July 1995): 19–26. https://doi.org/10.1097/00000658-199507000-00004.
Weltz CR, Greengrass RA, Lyerly HK. Ambulatory surgical management of breast carcinoma using paravertebral block. Ann Surg. 1995 Jul;222(1):19–26.
Weltz, C. R., et al. “Ambulatory surgical management of breast carcinoma using paravertebral block.Ann Surg, vol. 222, no. 1, July 1995, pp. 19–26. Pubmed, doi:10.1097/00000658-199507000-00004.
Weltz CR, Greengrass RA, Lyerly HK. Ambulatory surgical management of breast carcinoma using paravertebral block. Ann Surg. 1995 Jul;222(1):19–26.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

July 1995

Volume

222

Issue

1

Start / End Page

19 / 26

Location

United States

Related Subject Headings

  • Time Factors
  • Surgery
  • Patient Satisfaction
  • Nerve Block
  • Middle Aged
  • Humans
  • Female
  • Breast Neoplasms
  • Anesthesia, Spinal
  • Ambulatory Surgical Procedures