Regional - block anesthesia in breast surgery - Primarius Dr. Milos Počekovac

Regional - block anesthesia in breast surgery

Anna Dornik

Dr. Nemanja Dimić

Прим др Милош Почековац

is the safest and most optimal technique, not only for the short-term outcome (perioperative period) but also for the long-term outcome (recurrence).

Pain as a risk factor for recurrence:

suppression of the immune system
activation of the neuroendocrine system
sympathetic activation
activation of the hypothalamic-pituitary-adrenal axis
increasing the concentration of β-endorphin as an immunosuppressant

Anesthesiological techniques in breast surgery:

General anesthesia
Regional anesthesia

* thoracic epidural anesthesia
* local anesthetic infiltration
* intercostal blocks
* paravertebral block
* interfascial blocks

Interface blocks:

PECS 1 and 2
Serratus anterior plane block
Erector spinae plane block
Pecto intercostal facial block
Transversus thoracic plane block

Advantages of regional anesthesia, short-term outcome:

Perioperative analgesia
Reduced need for opioids
Reduced risk of postoperative vomiting
Reduced risk of pulmonary complications
Reduction of chronic and phantom pain after surgery
Reduced number of days spent in hospital (one day surgery)

Long-term outcome-reduces the progression of tumor cells:

by reducing “surgical” stress
good pain control
decreased use of opioids
direct effect of local anesthetics on the migration of tumor cells

Lidocaine and bupivacaine induce apoptosis of breast tumor cells – ideal for infiltration.

IF YOU NOTICE ANY CHANGE IN YOUR BREAST, BE SURE TO CALL YOUR DOCTOR!!!

BREAST SELF-EXAMINATION IS NOT A SUBSTITUTE FOR GOING TO THE ONCOSURGEON AND RADIOLOGY WHO PERFORMS BREAST ULTRASOUND AND MAMMOGRAPHY!!!