Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2017.58.270
A combination of levobupivacaine and lidocaine for paravertebral block in breast cancer patients undergoing quadrantectomy causes greater hemodynamic oscillations than levobupivacaine alone
Miroslav Župčić
orcid.org/0000-0002-1989-7255
; Clinic of Anesthesiology, Reanimatology and Intensive Care Medicine, ClinicalHospital Dubrava, Zagreb, Croatia
Sandra Graf Župčić
; Clinic of Neurology, Clinical Hospital “Sveti Duh“, Zagreb, and “J. J. Strossmayer” Facultyof Medicine, Osijek, Croatia
Viktor Duzel
; Department of Anaesthesia, Barking, Havering and Redbridge UniversityHospitals NHS Trust, London, United Kingdom
Tatjana Šimurina
orcid.org/0000-0002-2657-5537
; “J. J. Strossmayer” Faculty of Medicine, Osijek, Croatia
Livija Šakić
; Clinic of Anesthesiology, Reanimatology and Intensive Medicine, Clinical Hospital “Sveti Duh”, Zagreb, and “J. J. Strossmayer”Faculty of Medicine, Osijek, Croatia
Jurica Fudurić
; Department of Surgery, General Hospital Karlovac, Karlovac, Croatia
Jasminka Peršec
orcid.org/0000-0002-3777-8153
; Clinic of Anesthesiology, Reanimatology and Intensive Care Medicine, ClinicalHospital Dubrava, Zagreb, Croatia
Milan Milošević
orcid.org/0000-0001-9008-7645
; Andrija Štampar School of Public Health WHO Collaborative Centre forOccupational Health, University of ZagrebSchool of Medicine, Zagreb, Croatia
Zdenko Stanec
; Clinic for Plastic, Reconstructive and Aesthetic Surgery, Clinical HospitalDubrava, Zagreb, Croatia
Anđelko Korušić
orcid.org/0000-0002-8758-3485
; Clinic of Anesthesiology, Reanimatology and Intensive Care Medicine, ClinicalHospital Dubrava, Zagreb, Croatia
Stjepan Barišin
orcid.org/0000-0002-4840-4931
; Clinic of Anesthesiology, Reanimatology and Intensive Care Medicine, ClinicalHospital Dubrava, Zagreb, Croatia
Sažetak
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.
Method A prospective, single-center, randomized, double-
blinded, controlled 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 a visual analogue scale.
Results Although the use of 0.5% levobupivacaine with
2% lidocaine solution for PVB decreased the mean timeto-
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% lidocaine
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
reduced hemodynamic disturbances and prolonged the
analgesic effect.
Ključne riječi
Hrčak ID:
187394
URI
Datum izdavanja:
10.8.2017.
Posjeta: 604 *