Thoracic epidural versus general anaesthesia for MRM surgeries.
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Date
2016-07
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Abstract
Background: General anaesthesia is still the preferred technique
amongst many practitioners for oncologic breast surgeries.
However the TEA technique has a lot of advantages over the
conventional GA technique.
Objective: We attempted to evaluate the two techniques of
anaesthesia for MRM surgeries.
Materials and method: Sixty ASA I-II patients undergoing MRM
were randomly assigned to two study groups of 30 patients each.
In the TEA group( group T), an epidural catheter was inserted at
T7-T8 level, and 8-10 ml of 0.5% bupivacaine was titrated and
administered.GA (group G) was induced with 2mg/kg of propofol
and was maintained with Isoflurane ,intermittent inj.
Vecuronium and 70% N2O in oxygen. The authors evaluated the
adequacy of anesthesia, surgical condition, post anesthetic
recovery, post anesthetic analgesia and patients’ satisfaction.
Results: The intra operative haemodynamics was comparable in
between the two groups. The incidence of nausea and vomiting
was significantly lower in the TEA group ( 16.5% in group T and
39.6% in group G , P = 0.02).The mean immediate VAS score was
also lower in TEA group ( group T =2.4 , group G =5.8,P =
0.001).Aldrete recovery score was 9/10 in 1st hr in a significant
proportion in the TEA group (89.1% in group T v/s 59.4% in group
G , P = 0.003).Patient satisfaction was significantly higher. The
surgeons were however satisfied with both the methods.
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 and patient satisfaction.
Description
Keywords
MRM, thoracic epidural, general anesthesia, breast carcinoma
Citation
Lahiry S, Sharma D N, Mund M, Dhaarini R, Deshmukh H. Thoracic epidural versus general anaesthesia for MRM surgeries. International Journal of Medical and Dental Sciences. 2016 July; 5(2): 1125-1131.