Banca de QUALIFICAÇÃO: AMANDA LIRA DOS SANTOS LEITE

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : AMANDA LIRA DOS SANTOS LEITE
DATE: 29/09/2021
TIME: 10:00
LOCAL: google meet
TITLE:

Analysis of pain control of patients submitted to pectoral block (PEC) in radical mastectomies with axillary approach in an oncological hospital in Maceió

KEY WORDS:

Blockage, mastectomy, PEC, pain.

PAGES: 35
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Introduction: Patients submitted to mastectomies with axillary dissection suffer greatly from postoperative pain and discomfort, so we sought to study regional blockade techniques that could minimize this effect, such as interpecal block (PEC). This technique may become an analgesic option widely used in axillary surgery due to the low rate of complications and the characteristic technique of single puncture that allows simultaneous blockade of several dermatomes, probably reducing postoperative pain and reducing the abusive use of opioids and their complications. Objectives: To evaluate the efficacy of pec anesthetic block alone when compared to the use of intravenous analgesics in the postoperative period of radical mastectomy, to evaluate complications from opioids and PEC block, to analyze the average consumption of opioids within 24 hours and cost-benefit of performing the blockade. Methodology: Randomized, controlled clinical trial with 78 patients with breast cancer who underwent mastectomy with axillary approach. Randomized 2 groups, one control, with exclusive general anesthesia and another group that received general anesthesia and PEC block with Levobupivacaine/Ropivacaine (infiltration of 10 ml between pectoral muscles and 20 ml between the pectoralis minor and serrátil), guided by intraoperative ultrasound. Prescription of Novalgina, Tramadol and morphine if necessary were offered post-surgery. In 24 hours postoperatively, a questionnaire was applied with the EVA pain scale and the statistical analysis of data used the Shapiro-Wilk test to assess the normality of the data, and the Mann-Whitney test for comparison between the groups. Chi-square was used to compare proportions. The data were analyzed by sigmaplot software 12. Results: Pain was observed, according to the VAS scale, on average, lower in the group with PEC (1.08) than in the group without PEC (1.56). This difference, however, was not statistically significant (p = 0.186). The percentage of participants who used analgesics in the group with PEC (45.9%, 17/37) was lower than the percentage of patients in the group without PEC (58.5%, 24/41), but without statistical significance (p = 0.2689). The percentage of those who used opioids in the groups with PEC (18.92%, 7/37) and without PEC (23.80%, 10/41) was equivalent (p = 0.6026), although higher in the group without PEC. The total amount of opioid consumed in the group without PEC was higher (1010 mg) than in the group with PEC (620 mg), but comparison of mean use was equivalent (p = 0.454). There was a low rate of complications such as PONV in both groups. Conclusion: Pec blockade showed a slight improvement in the quality of analgesia, reduced analgesic consumption after surgery in breast cancer, and presented a low rate of complications, and may be a first-line option for analgesia in breast surgeries, however, it was not possible to prove its superiority in the control of postoperative pain over the course of 24 hours in relation to exclusive intravenous analgesia used intraoperatively.

BANKING MEMBERS:
Presidente - 2269479 - CAROLINNE DE SALES MARQUES
Interno - 2361727 - CARLOS ALBERTO DE CARVALHO FRAGA
Externa ao Programa - 2363781 - AMANDA KARINE BARROS FERREIRA RODRIGUES
Externo à Instituição - FREDERICO THEOBALDO RAMOS ROCHA - NENHUMA