Analysis of The Safety and Efficacy of Different Types of Anesthesiological Support During Aesthetic Interventions For The Breast Glands In Ukraine
Life Sciences-Medicine
DOI:
https://doi.org/10.22376/ijpbs/lpr.2022.12.6.SP23.L1-6Keywords:
Aesthetic Interventions, Mammary Glands, Propofol, Sevoflurane, Combined AnesthesiaAbstract
In the prevailing era, mammoplasty is prevalent among women. Undeniable benefits of the method are the preservation of most anatomical structures and skin, and also better psychological status of patients after intervention. Hence, the present study intends to examine the features of aesthetic and reduction surgical interventions on the mammary glands in Ukraine. Materials and methods. The study was conducted by analyzing the inpatient ambulatory cards of 320 patients. Anesthesia was provided by propofol (n=130), sevoflurane (n=140) and combined use of sevoflurane and nalbuphine (n=50). The results of the study. It was found that usage of combined inhalation analgesia of sevoflurane with opioids was characterized by 41.9% less recovery time. It was found that 8 hours after surgery, the individual assessment of pain was lower in the group of combined analgesia with opioids relative to intravenous anesthesia with propofol (87.5%, p<0.05) and inhalation anesthesia with sevoflurane (71, 3%, p<0.05). After 24 hours all patients reported about pain below 1.0 point, however, in groups where sevoflurane and nalbuphine were used, the level of pain self-esteem was 2.61 and 3 times lower than after intravenous propofol. It was found that within 1 hour after surgery, the average cognitive score on the Montreal scale decreased in the group of intravenous propofol by 5.0% (p<0.05) and by 1.7% under inhalation anesthesia with sevoflurane. Under combined anesthesia the cognitive score remained at 12.0 points. The frequency of postoperative nausea was the highest level in the group of inhalation anesthesia - 16.7%. The addition of nalbuphine to sevoflurane significantly reduced the risk of postoperative nausea (? 2=7.250; p=0.007). Conclusions. Combined anesthesia with opioids is a highly effective anesthetic choice for aesthetic and reconstructive interventions on the mammary glands.
References
Sherwin A., Buggy D. J. Anaesthesia for breast surgery. BJA Educ, 2018; 18(11): 342-348. https://doi.org/10.1016/j.bjae.2018.08.002.
Lundström S., Twycross R., Mihalyo M., Wilcock A. Propofol. J. Pain Symptom Manag, 2010. 40(3): 466–470. https://doi.org/10.1016/j.jpainsymman.2010.07.001
Rowland J. H., Desmond K. A., Meyerowitz B. E. Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J.Natio. Cancer Instute, 2000; 92(17): 1422-1429. https://doi.org/10.1093/jnci/92.17.1422
Zheng J-W., Meng B., Li X-Y., Lu B., Wu G-R., Chen J-P.NF-κB/P65 signaling pathway: a potential therapeutic target in postoperative cognitive dysfunction after sevoflurane anesthesia. Eur Rev Med Pharmacol Sci, 2017; 21(2): 394–407. https://doi.org/10.17219/acem/134740
Qin G., Luo H., Yin X., Wang L., Zhang J., Cao Y., Zhang Z., Ye, Z., Wang E. Effects of Sevoflurane on Hemodynamics and Inducible Nitric Oxide Synthase/Soluble Guanylate Cyclase Signaling Pathway in a Rat Model of Pulmonary Arterial Hypertension. Anesth Analg, 2017; 125(1):184–189. https://doi.org/10.1213/ANE.0000000000001937.
Claroni C., Torregiani G., Covotta M., Sofra M., Scotto Di Uccio A., Marcelli M., Naccarato A., Forastiere E. Protective effect of sevoflurane preconditioning on ischemia-reperfusion injury in patients undergoing reconstructive plastic surgery with microsurgical flap, a randomized controlled trial. BMC Anesthesiol, 2016; 16(1): 66. https://doi.org/10.1186/s12871-016-0230-1.
Lim J., Oh C., Yoon T-G., Lee J.Y., Lee S-H., Yoo Y-B., Yang J-H., Kim S-H. The effect of propofol and sevoflurane on cancer cell, natural killer cell, and cytotoxic T lymphocyte function in patients undergoing breast cancer surgery: an in vitro analysis. BMC Cancer, 2018; 18(1): 159. https://doi.org/10.1186/s12885-018-4064-8.
Chen H-P., Hsu Y-H., Hua K-C., Lin C-C., Lo Y-F., Yu H-P. Comparison of sevoflurane versus propofol under auditory evoked potential monitoring in female patients undergoing breast surgery. Biomed J, 2013; 36(3) :125–131. https://doi.org/10.4103/2319-4170.113228
Erb T., von Ungern-Sternberg B., Moll J., Frei F. Impact of high concentrations of sevoflurane on laryngeal reflex responses. Paediatr Anaesth, 2017; 27(3): 282–289. https://doi.org/10.1111/pan.13062
Sharma S., Chang D. W., Koutz C. Incidence of hematoma associated with ketorolac after TRAM flap breast reconstruction. Plast Reconstr Surg, 2001; 107(2): 352–355. https://doi.org/10.1097/00006534-200102000-00009
Kocaturk O., Keles S. Recovery characteristics of total intravenous anesthesia with propofol versus sevoflurane anesthesia: a prospective randomized clinical trial. J Pain Res, 2018; 11: 1289–1295. https://doi.org/10.2147/JPR.S164106.
Çaparlar C. Ö., Özhan M. O., Süzer M. A. Fast-track anesthesia in patients undergoing outpatient laparoscopic cholecystectomy: comparison of sevoflurane with total intravenous anesthesia. J. Clin. Anesth, 2017; 37: 25–30. https://doi.org/10.1016/j.jclinane.2016.10.036
Heimes A. S., Stewen K., Hasenburg A. Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction. Breast Care (Basel), 2017; 12(6): 374–377. https://doi.org/10.1159/000485234
Filip C. I., Jecan C. R., Raducu L. Immediate Versus Delayed Breast Reconstruction for Postmastectomy Patients. Controversies and Solutions. Chirurgia (Bucur), 2017; 112(4): 378–86. https://doi.org/10.21614/chirurgia.112.4.378
Hart A. M., Broecker J. S., Kao L., Losken A. Opioid use following outpatient breast surgery: are physicians part of the problem? Plast. Reconstr. Surg, 2018; 142(3): 611–620. https://doi.org/10.1097/PRS.0000000000004636
Frauenknecht J., Kirkham K. R., Jacot-Guillarmod A., Albrecht E. Analgesic impact of intra-operative opioids vs. opioid-free anaesthesia: a systematic review and meta-analysis. Anaesthesia, 2019; 74(5): 651–662. https://doi.org/10.1111/anae.14582
Mulier J. P. Is opioid-free general anesthesia for breast and gynecological surgery a viable option? Curr Opin Anaesthesiol, 2019; 32(3): 257–262. https://doi.org/10.1097/ACO.0000000000000716
Sun H., Zhang G., Ai B., Zhang H., Kong X., Le W-T. A systematic review: comparative analysis of the effects of propofol and sevoflurane on postoperative cognitive function in elderly patients with lung cancer. BMC Cancer, 2019; 19(1): 1248. https://doi.org/10.1186/s12885-019-6426-2
Parida S., Badhe A.S. Comparison of cognitive, ambulatory, and psychomotor recovery profiles after day care anesthesia with propofol and sevoflurane. J Anesth, 2014; 28(6): 833–838. https://doi.org/10.1007/s00540-014-1827-5
Haseneder R., Starker L., Berkmann J., Kellermann K., Jungwirth B., Blobner M., Eder M., Kochs E., Rammes G. Sevoflurane anesthesia improves cognitive performance in mice, but does not influence in vitro long-term potentation in hippocampus CA1 stratum radiatum. PLoS One, 2013; 8(5): e64732. https://doi.org/10.1371/journal.pone.0064732
Xu T., Bo L., Wang J., Zhao Z., Xu Z., Deng X. Risk factors for early postoperative cognitive dysfunction after non-coronary bypass surgery in Chinese population. J Cardiothorac Surg, 2013; 8: 204. https://doi.org/10.1186/1749-8090-8-204
Geng Y-J., Wu Q-H., Zhang R-Q. Effect of propofol, sevoflurane, and isoflurane on postoperative cognitive dysfunction following laparoscopic cholecystectomy in elderly patients: A randomized controlled trial. J Clin Anesth, 2017; 38: 165–171. https://doi.org/10.1016/j.jclinane.2017.02.007
Tian H-T., Duan X-H., Yang Y-F., Wang Y., Bai Q-L., Zhang X. Effects of propofol or sevoflurane anesthesia on the perioperative inflammatory response, pulmonary function and cognitive function in patients receiving lung cancer resection. Eur Rev Med Pharmacol Sci, 2017; 21(23): 5515–5522. https://doi.org/10.26355/eurrev_201712_13943
Chen I., Kang Y-N., Wang H-J., Chiu, W-K., & Chen, C. The Efficacy of Local Anesthesia for Postoperative Pain Control in Breast Augmentation Surgery: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Aesthetic Plastic Surgery, 2022; 1-10. https://doi.org/10.1007/s00266-022-02815-9
Published
How to Cite
Issue
Section
Copyright (c) 2022 Iurii Kuchyn, Dmytro Sazhyn, Gennadiy Patlazhan

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

