A COMPARATIVE STUDY OF OUTCOMES AFTER MODIFIED RADICAL MASTECTOMY DONE UNDER THORACIC EPIDURAL vs. GENERAL ANAESTHESIA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 25
Abstract
BACKGROUND In earlier days General Anaesthesia (GA) was the choice for MRM, but recently Thoracic Epidural (TE) analgesia is being increasingly used for MRM. TE technique has a lot of advantages over the conventional GA technique. MATERIALS AND METHODS 100 patients with carcinoma breast are divided into two groups- Thoracic Epidural (TE) and General Anaesthesia (GA) of 50 patients each. Four patients in TE group were converted to GA in view of patient’s anxiety during surgery. All the intraoperative parameters heart rate, blood pressure, bleeding and postoperative outcomes, seroma formation, drains, wound infection rates, flap necrosis and hospital stay are recorded. RESULTS The demographic data showed no differences between both groups. During the intraoperative period, hypertension and tachycardia were more frequent in GA group while hypotension and bradycardia more in TE group, which was statistically significant (p value <0.05). In the immediate postoperative period, nausea and vomiting were more in GA group (31%) than in TE group (8.6%), which was statistically significant (p value 0.01). Also, pain scores were more in GA group than in TE group. Wound infection rates, seroma incidence, flap necrosis, length of hospital stay and hospital costs were less in TE group than GA group. CONCLUSION Use of thoracic epidural technique as a sole anaesthetic technique for MRM surgeries provides adequate operating conditions, better side effect profile, better pain management, less postoperative complications, early ambulation, early drain removal and early discharge from the hospital.
Authors and Affiliations
Jakkula Kishore, Satya Srinivas P, Tadepalli V. N Sarat Chandu, Kamesh P
Keywords
Related Articles
- EP ID EP217036
- DOI 10.18410/jebmh/2017/280
- Views 114
- Downloads 0
IS MINIMAL INCISION THYROID SURGERY A BETTER ALTERNATIVE TO CONVENTIONAL AND ENDOSCOPIC THYROID SURGERY FOR SOLITARY THYROID NODULE?
The conventional technique of thyroidectomy for solitary thyroid nodule requires long skin incision, not satisfying patient and surgeon in terms of cosmesis and endoscopic thyroid surgery requires expertise. In our study...
A CLINICAL STUDY OF PLANTAR ULCERS IN LEPROSY
BACKGROUND Deformity prevention is one of the top priorities in leprosy elimination programme. Plantar ulcer and foot deformities are commonly seen in leprosy patients causing considerable physical disability. This can b...
A COMPARATIVE STUDY BETWEEN CONVENTIONAL AND COLLAGEN DRESSING IN THE HEALING OF FOOT ULCERS
BACKGROUND Foot ulcer is a major disease-causing disability to many patients around the world. Treatment of foot ulcer remains a major healthcare issue; and especially diabetic foot ulcer accounts for 15% of incidence wh...
POST-TRAUMATIC FRACTURE NON-UNION OF PROXIMAL HUMERUS WITH COMPROMISED ROTATOR CUFF TREATED WITH REVERSE SHOULDER ARTHROPLASTY: A CASE REPORT
We here with present a case of post-traumatic fracture non-union of proximal humerus with compromised rotator cuff in a 50 yrs old retired BSF jawan, who presented to our OPD with a chief complaint of pain, decreased ROM...
RARE TUMOUR MIMICKING THE COMMON: A CASE REPORT
BACKGROUND Ameloblastoma is the most common benign odontogenic tumour of the jaws, involving mandible and maxilla. It is a rare tumour & constitutes about 1% of all tumours of the jaw and about 9-11% of odontogenic tumou...