A combination of levobupivacaine and lidocaine for paravertebral block in breast cancer patients undergoing quadrantectomy causes greater hemodynamic oscillations than levobupivacaine alone (CROSBI ID 242043)
Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija
Podaci o odgovornosti
Župčić, Miroslav ; Graf Župčić, Sandra ; Đuzel, Viktor ; Šimurina, Tatjana ; Šakić, Livija ; Fudurić, Jurica ; Peršec, Jasminka ; Milošević, Milan ; Stanec, Zdenko ; Korušić, Anđelko ; Barišin, Stjepan.
engleski
A combination of levobupivacaine and lidocaine for paravertebral block in breast cancer patients undergoing quadrantectomy causes greater hemodynamic oscillations than levobupivacaine alone
AIM: To test for differences in hemodynamic and analgesic properties in patients with breast cancer undergoing quadrantectomy with paravertebral block (PVB) induced with a solution of either one or two local anesthetics. METHODS: A prospective, single-center, randomized, double-blinded, control trial was conducted from June 2014 until September 2015. A total of 85 women with breast cancer were assigned to receive PVB with either 0.5% levobupivacaine (n=42) or 0.5% levobupivacaine with 2% lidocaine (n=43). Hemodynamic variables of interest included intraoperative stroke volume variation (SVV), mean arterial pressure, heart rate, cardiac output, episodes of hypotension, use of crystalloids, and use of inotropes. Analgesic variables of interest were time to block onset, duration of analgesia, and postoperative serial pain assessment using visual analogue scale. RESULTS: Although the use of 0.5% levobupivacaine with 2% lidocaine solution for PVB decreased time to the block onset (14 minutes ; P<0.001), it also caused significantly higher SVV values over the 60 minutes of monitoring (mean difference 4.33 ; P<0.001). Furthermore, the patients who received 0.5% levobupivacaine with 2% lidoacine experienced shorter mean duration of analgesia (105 minutes ; P= 0.006)and more episodes of hypotension (17.5% ; P= 0.048) and received more intraoperative crystalloids (mean volume:550 ml ; P<0.001). CONCLUSION: The use of 0.5% levobupivacaine in comparison with 0.5% levobupivacaine with 2% lidocaine solution for PVB had a longer time-to-block onset, but it also reduces hemodynamic disturbances and prolongs analgesic effect. Registration No: NTC02004834
synergistic effect ; local anesthetics ; hemodynamic changes
nije evidentirano
nije evidentirano
nije evidentirano
nije evidentirano
nije evidentirano
nije evidentirano
Podaci o izdanju
58 (4)
2017.
270-280
objavljeno
0353-9504
1332-8166
10.3325/cmj.2017.58.270
Povezanost rada
Kliničke medicinske znanosti