The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy
Background and Aims. Regional anaesthesia reports to attenuate stress and inflammatory responses associated with surgical resection; however, the effectiveness of combined nerve blocks is less often investigated. We evaluated whether a combination of a pectoral nerve block (PNB) and stellate ganglio...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | International Journal of Breast Cancer |
| Online Access: | http://dx.doi.org/10.1155/2022/3359130 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562211608854528 |
|---|---|
| author | Jun Geng Jing Wang Yaowen Zhang Wenxiang Song Junjia Zhu Jianqing Chen Zhen Wu |
| author_facet | Jun Geng Jing Wang Yaowen Zhang Wenxiang Song Junjia Zhu Jianqing Chen Zhen Wu |
| author_sort | Jun Geng |
| collection | DOAJ |
| description | Background and Aims. Regional anaesthesia reports to attenuate stress and inflammatory responses associated with surgical resection; however, the effectiveness of combined nerve blocks is less often investigated. We evaluated whether a combination of a pectoral nerve block (PNB) and stellate ganglion block (SGB) is more effective than a PNB alone in reducing these responses in women undergoing modified radical mastectomy (MRM). Methods. This is a prospective randomized controlled trial. Fifty patients with breast cancer were randomly allocated to receive an ultrasound-guided PNB (n=25, PNB only group) or ultrasound-guided PNB combined with SGB (n=25, combined blockade group). The primary outcome was perioperative plasma level of interleukin- (IL-) 6. Secondary outcomes included perioperative plasma levels of cortisol, glucose, IL-8, and tumour necrosis factor- (TNF-) α, pain scores, haemodynamic variables, sleep quality, and complications postsurgery. Results. The combined blockade group exhibited significantly lower IL-6 and TNF-α levels 24 h postsurgery. Cortisol levels were significantly lower in the combined blockade group at the end of the surgery. Glucose levels at the time of incision were lower in the combined blockade group. Pain scores up to 12 h postsurgery were significantly lower in the combined blockade group, which also exhibited better perioperative haemodynamic stability. Patients in the combined blockade group reported better sleep quality on the night of surgery. Conclusion. In patients undergoing MRM, PNB combined with SGB block effectively blunted perioperative inflammatory response than PNB alone. A combined block approach can also alleviate stress response and postoperative acute pain with stable perioperative haemodynamics and better postoperative sleep quality. |
| format | Article |
| id | doaj-art-b424d823ee624080ad37c6cd8bca1272 |
| institution | Kabale University |
| issn | 2090-3189 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Breast Cancer |
| spelling | doaj-art-b424d823ee624080ad37c6cd8bca12722025-02-03T01:23:15ZengWileyInternational Journal of Breast Cancer2090-31892022-01-01202210.1155/2022/3359130The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical MastectomyJun Geng0Jing Wang1Yaowen Zhang2Wenxiang Song3Junjia Zhu4Jianqing Chen5Zhen Wu6Department of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of General SurgeryDepartment of AnesthesiologyDepartment of AnesthesiologyBackground and Aims. Regional anaesthesia reports to attenuate stress and inflammatory responses associated with surgical resection; however, the effectiveness of combined nerve blocks is less often investigated. We evaluated whether a combination of a pectoral nerve block (PNB) and stellate ganglion block (SGB) is more effective than a PNB alone in reducing these responses in women undergoing modified radical mastectomy (MRM). Methods. This is a prospective randomized controlled trial. Fifty patients with breast cancer were randomly allocated to receive an ultrasound-guided PNB (n=25, PNB only group) or ultrasound-guided PNB combined with SGB (n=25, combined blockade group). The primary outcome was perioperative plasma level of interleukin- (IL-) 6. Secondary outcomes included perioperative plasma levels of cortisol, glucose, IL-8, and tumour necrosis factor- (TNF-) α, pain scores, haemodynamic variables, sleep quality, and complications postsurgery. Results. The combined blockade group exhibited significantly lower IL-6 and TNF-α levels 24 h postsurgery. Cortisol levels were significantly lower in the combined blockade group at the end of the surgery. Glucose levels at the time of incision were lower in the combined blockade group. Pain scores up to 12 h postsurgery were significantly lower in the combined blockade group, which also exhibited better perioperative haemodynamic stability. Patients in the combined blockade group reported better sleep quality on the night of surgery. Conclusion. In patients undergoing MRM, PNB combined with SGB block effectively blunted perioperative inflammatory response than PNB alone. A combined block approach can also alleviate stress response and postoperative acute pain with stable perioperative haemodynamics and better postoperative sleep quality.http://dx.doi.org/10.1155/2022/3359130 |
| spellingShingle | Jun Geng Jing Wang Yaowen Zhang Wenxiang Song Junjia Zhu Jianqing Chen Zhen Wu The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy International Journal of Breast Cancer |
| title | The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy |
| title_full | The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy |
| title_fullStr | The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy |
| title_full_unstemmed | The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy |
| title_short | The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy |
| title_sort | effect of a combined modified pectoral and stellate ganglion block on stress and inflammatory response in patients undergoing modified radical mastectomy |
| url | http://dx.doi.org/10.1155/2022/3359130 |
| work_keys_str_mv | AT jungeng theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT jingwang theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT yaowenzhang theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT wenxiangsong theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT junjiazhu theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT jianqingchen theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT zhenwu theeffectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT jungeng effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT jingwang effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT yaowenzhang effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT wenxiangsong effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT junjiazhu effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT jianqingchen effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy AT zhenwu effectofacombinedmodifiedpectoralandstellateganglionblockonstressandinflammatoryresponseinpatientsundergoingmodifiedradicalmastectomy |