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Fascial plane blocks for breast surgery – current state of knowledge

Breast surgeries belong to the most frequently performed procedures and are often associated with a high intensity of pain in the postoperative period. Regional anesthesia techniques, and paravertebral block, have been the gold standard of postoperative pain management for major breast cancer surger...

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Autores principales: Gola, Wojciech, Białka, Szymon, Andrzejewska, Agata, Palaczynski, Piotr, Misiołek, Hanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156513/
https://www.ncbi.nlm.nih.gov/pubmed/36062421
http://dx.doi.org/10.5114/ait.2022.119220
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author Gola, Wojciech
Białka, Szymon
Andrzejewska, Agata
Palaczynski, Piotr
Misiołek, Hanna
author_facet Gola, Wojciech
Białka, Szymon
Andrzejewska, Agata
Palaczynski, Piotr
Misiołek, Hanna
author_sort Gola, Wojciech
collection PubMed
description Breast surgeries belong to the most frequently performed procedures and are often associated with a high intensity of pain in the postoperative period. Regional anesthesia techniques, and paravertebral block, have been the gold standard of postoperative pain management for major breast cancer surgeries. In recent years, the development of new techniques of regional anesthesiology, which is due to the extensive implementation of ultrasound imaging, has enabled the use of a number of new blockades. The “new players” in regional anesthesiology include numerous fascial plane blocks. Fascial plane blocks are often technically easier and less invasive compared to, for example, paravertebral blockade. The core mechanism of action in fascial blocks consists in blocking the nerve structures that supply a certain area of the trunk after deposition of local anesthetic (LA) within the fascial and fasciomuscular compartments. In addition to direct nerve blockade, there are other potential mechanisms of analgesia such as systemic effects. This idea differs from the traditional concept of nerve and plexus blocks, but it should be remembered that the final effect of a fascial plane block and its extent can be extremely variable across individual cases. According to the current state of knowledge, an alternative to paravertebral blockade may be PECS blockade. The available options also include erector spinae plane block (ESPB) and serratus plane block (SPB), however their recommendation in breast surgery requires more extensive scientific evidence.
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spelling pubmed-101565132023-05-17 Fascial plane blocks for breast surgery – current state of knowledge Gola, Wojciech Białka, Szymon Andrzejewska, Agata Palaczynski, Piotr Misiołek, Hanna Anaesthesiol Intensive Ther Review Articles Breast surgeries belong to the most frequently performed procedures and are often associated with a high intensity of pain in the postoperative period. Regional anesthesia techniques, and paravertebral block, have been the gold standard of postoperative pain management for major breast cancer surgeries. In recent years, the development of new techniques of regional anesthesiology, which is due to the extensive implementation of ultrasound imaging, has enabled the use of a number of new blockades. The “new players” in regional anesthesiology include numerous fascial plane blocks. Fascial plane blocks are often technically easier and less invasive compared to, for example, paravertebral blockade. The core mechanism of action in fascial blocks consists in blocking the nerve structures that supply a certain area of the trunk after deposition of local anesthetic (LA) within the fascial and fasciomuscular compartments. In addition to direct nerve blockade, there are other potential mechanisms of analgesia such as systemic effects. This idea differs from the traditional concept of nerve and plexus blocks, but it should be remembered that the final effect of a fascial plane block and its extent can be extremely variable across individual cases. According to the current state of knowledge, an alternative to paravertebral blockade may be PECS blockade. The available options also include erector spinae plane block (ESPB) and serratus plane block (SPB), however their recommendation in breast surgery requires more extensive scientific evidence. Termedia Publishing House 2022-09-02 /pmc/articles/PMC10156513/ /pubmed/36062421 http://dx.doi.org/10.5114/ait.2022.119220 Text en Copyright © Polish Society of Anaesthesiology and Intensive Therapy https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/) ), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Review Articles
Gola, Wojciech
Białka, Szymon
Andrzejewska, Agata
Palaczynski, Piotr
Misiołek, Hanna
Fascial plane blocks for breast surgery – current state of knowledge
title Fascial plane blocks for breast surgery – current state of knowledge
title_full Fascial plane blocks for breast surgery – current state of knowledge
title_fullStr Fascial plane blocks for breast surgery – current state of knowledge
title_full_unstemmed Fascial plane blocks for breast surgery – current state of knowledge
title_short Fascial plane blocks for breast surgery – current state of knowledge
title_sort fascial plane blocks for breast surgery – current state of knowledge
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156513/
https://www.ncbi.nlm.nih.gov/pubmed/36062421
http://dx.doi.org/10.5114/ait.2022.119220
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