| Multimodal prevention of pain, nausea and vomiting after breast cancer surgery. | |
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MedLine Citation:
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PMID: 20935616 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite many one- or two-modal attempts to relieve postoperative nausea and vomiting (PONV) and pain, postoperative issues following breast cancer surgery remain a substantial problem. Therefore, the aim of this explorative, hypothesis-generating study was to evaluate the effect of a multimodal, opiate-sparing, evidence-based regimen for prevention of PONV and pain. METHODS: Two hundred consecutive patients scheduled for breast cancer surgery were included. The prevention regimen included a package consisting of preoperative paracetamol, dextromethorphan, celecoxib, gabapentin, dexamethasone, total intravenous anaesthesia and intraoperative ondansetron. The patients were prospectively scored according to PONV, pain during rest and mobilization and major side effects. RESULTS: Of 200 consecutive breast cancer patients, 191 received the full package. During the first 36 postoperative hours, 79.1% reported no PONV at all and only 3.7% reported severe PONV. At rest, 69.6% reported no or light pain and 3.1% reported severe pain, with corresponding values of 59.7% and 8.9% during arm mobilization. Mean postoperative morphine consumption was 2.2 mg. The only significant side effect was transient dizziness. CONCLUSION: A multimodal, opiate-sparing regimen to prevent pain and PONV seems to be more effective than one- or two-component regimens on PONV and pain after breast cancer surgery, a result which calls for large-scale multi-center or randomized studies. |
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Authors:
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R Gärtner; N Kroman; T Callesen; H Kehlet |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Minerva anestesiologica Volume: 76 ISSN: 1827-1596 ISO Abbreviation: Minerva Anestesiol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-11 Completed Date: 2011-01-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375272 Medline TA: Minerva Anestesiol Country: Italy |
Other Details:
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Languages: eng Pagination: 805-13 Citation Subset: IM |
Affiliation:
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Department of Breast Cancer Surgery, Rigshospitalet, Copenhagen University, Denmark. runegartner@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetaminophen
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administration & dosage,
adverse effects,
therapeutic use Aged Amines / administration & dosage, adverse effects, therapeutic use Analgesics, Non-Narcotic / administration & dosage, adverse effects, therapeutic use* Anesthesia Recovery Period Anesthesia, Intravenous Antiemetics / administration & dosage, adverse effects, therapeutic use* Breast Neoplasms / surgery* Combined Modality Therapy Cyclohexanecarboxylic Acids / administration & dosage, adverse effects, therapeutic use Dexamethasone / administration & dosage, adverse effects, therapeutic use Dextromethorphan / administration & dosage, adverse effects, therapeutic use Female Fentanyl Humans Intraoperative Care Lymph Node Excision Mastectomy* Middle Aged Morphine / adverse effects, therapeutic use Narcotics / adverse effects, therapeutic use Nervous System Diseases / chemically induced Ondansetron / administration & dosage, adverse effects, therapeutic use Pain, Postoperative / etiology, prevention & control* Pilot Projects Postoperative Nausea and Vomiting / etiology, prevention & control* Preanesthetic Medication* Pyrazoles / administration & dosage, adverse effects, therapeutic use Sentinel Lymph Node Biopsy Sulfonamides / administration & dosage, adverse effects, therapeutic use gamma-Aminobutyric Acid / administration & dosage, adverse effects, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Amines; 0/Analgesics, Non-Narcotic; 0/Antiemetics; 0/Cyclohexanecarboxylic Acids; 0/Narcotics; 0/Pyrazoles; 0/Sulfonamides; 103-90-2/Acetaminophen; 125-71-3/Dextromethorphan; 169590-42-5/celecoxib; 437-38-7/Fentanyl; 50-02-2/Dexamethasone; 56-12-2/gamma-Aminobutyric Acid; 57-27-2/Morphine; 60142-96-3/gabapentin; 99614-02-5/Ondansetron |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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