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The trajectory of postoperative pain following mastectomy with and without paravertebral block

Wynne, Rochelle, Lui, N, Tytler, K, Koffsovitz, C, Kirwa, V, Riedel, B and Ryan, S 2017, The trajectory of postoperative pain following mastectomy with and without paravertebral block, Pain management nursing, vol. 18, no. 4, pp. 1-9, doi: 10.1016/j.pmn.2017.03.003.

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Title The trajectory of postoperative pain following mastectomy with and without paravertebral block
Author(s) Wynne, Rochelle
Lui, N
Tytler, K
Koffsovitz, C
Kirwa, V
Riedel, B
Ryan, S
Journal name Pain management nursing
Volume number 18
Issue number 4
Start page 1
End page 9
Total pages 9
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2017-06-07
ISSN 1524-9042
1532-8635
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Nursing
LENGTH-OF-STAY
BREAST SURGERY
GENERAL-ANESTHESIA
MANAGEMENT ALGORITHM
NURSES
METAANALYSIS
CANCER
TRIAL
Summary Evidence to support the argument that general anesthesia (GA) with paravertebral block (PVB) provides better pain relief for mastectomy patients than GA alone is contradictory. The aim of this study was to explore pain and analgesia after mastectomy with or without PVB during acute inpatient recovery. A retrospective study was conducted in a single hospital providing specialist cancer services in metropolitan Melbourne, Australia. We explored pain and concomitant analgesic administration in 80 consecutive women recovering from mastectomy who underwent GA with (n = 40) or without (n = 40) PVB. A pain management index (PMI) was derived to illustrate the efficacy of management from day of surgery (DOS) to postoperative day (POD) 3. Patients who reported no pain progressively increased from DOS (n = 12, 15%) to POD 3 (n = 54, 67.5%). Most patients were administered analgesics as a combination of acetaminophen and a strong opioid on DOS (n = 53, 66.2%), POD 1 (n = 45, 56.2%), POD 2 (n = 33, 41.2%), and POD 3 (n = 21, 26.2%). Less than 6% of patients on any POD were administered multimodal anlagesics. PMI scores indicate some pain in the context of receiving weak and strong opioids for GA patients and more frequent use of nonopioid analgesics in PVB patients during recovery. These findings highlight the need for data describing patterns of analgesic administration in addition to reports of postoperative pain to determine the most effective means of avoiding postoperative pain in patients who require mastectomy.
Language eng
DOI 10.1016/j.pmn.2017.03.003
Field of Research 111099 Nursing not elsewhere classified
1110 Nursing
1103 Clinical Sciences
1701 Psychology
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, American Society for Pain Management Nursing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30098637

Document type: Journal Article
Collections: School of Nursing and Midwifery
Centre for Quality and Patient Safety
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