Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery
Background. Effects of perioperative cervical level neuraxial blocks on the dissemination of cancer metastases have become a matter of substantial interest. However, experience with these catheters has been limited and data on feasibility and efficacy is sparse. Methods. Data from 39 patients schedu...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2017/7024924 |
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| author | Manuel Wenk Christina Massoth Daniel M. Pöpping Michael Möllmann |
| author_facet | Manuel Wenk Christina Massoth Daniel M. Pöpping Michael Möllmann |
| author_sort | Manuel Wenk |
| collection | DOAJ |
| description | Background. Effects of perioperative cervical level neuraxial blocks on the dissemination of cancer metastases have become a matter of substantial interest. However, experience with these catheters has been limited and data on feasibility and efficacy is sparse. Methods. Data from 39 patients scheduled to undergo breast cancer surgery while awake with a cervical epidural alone was retrospectively analyzed. Results. In 26 patients (66,7%, 95% CI 51,7–81,7) the cervical epidural catheter was sufficient for surgery. In one patient (2.6%, 95% CI 0–7.6) identification of the epidural space was not possible. Four patients (10.3%, 95% CI 0,7–19,9) had an insufficient sensory block. Seven patients (17.9%, 95% CI 5,7–30,1) had a partially insufficient sensory block. Rates of failed epidural blocks were not significantly different between different insertion levels. 21 patients (80.8%, 95% CI 65,4–96,1) developed hypotension and required an intravenous vasopressor. One patient developed nausea. In one patient the dura was accidentally punctured. No neurological damage was observed. No other major complications were observed. Discussion. Epidural punctures in the cervical region are feasible but do bear potential for major complications. Anesthesiologists should familiarize themselves with high epidural block techniques. |
| format | Article |
| id | doaj-art-a17006f6d89d4d9c8008ae8ec07bd4f6 |
| institution | OA Journals |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-a17006f6d89d4d9c8008ae8ec07bd4f62025-08-20T02:20:41ZengWileyAnesthesiology Research and Practice1687-69621687-69702017-01-01201710.1155/2017/70249247024924Feasibility of Cervical Epidural Anesthesia for Breast Cancer SurgeryManuel Wenk0Christina Massoth1Daniel M. Pöpping2Michael Möllmann3Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, GermanyDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, GermanyDepartment of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, GermanyDepartment of Anesthesiology and Intensive Care, St. Franziskus Hospital, Muenster, GermanyBackground. Effects of perioperative cervical level neuraxial blocks on the dissemination of cancer metastases have become a matter of substantial interest. However, experience with these catheters has been limited and data on feasibility and efficacy is sparse. Methods. Data from 39 patients scheduled to undergo breast cancer surgery while awake with a cervical epidural alone was retrospectively analyzed. Results. In 26 patients (66,7%, 95% CI 51,7–81,7) the cervical epidural catheter was sufficient for surgery. In one patient (2.6%, 95% CI 0–7.6) identification of the epidural space was not possible. Four patients (10.3%, 95% CI 0,7–19,9) had an insufficient sensory block. Seven patients (17.9%, 95% CI 5,7–30,1) had a partially insufficient sensory block. Rates of failed epidural blocks were not significantly different between different insertion levels. 21 patients (80.8%, 95% CI 65,4–96,1) developed hypotension and required an intravenous vasopressor. One patient developed nausea. In one patient the dura was accidentally punctured. No neurological damage was observed. No other major complications were observed. Discussion. Epidural punctures in the cervical region are feasible but do bear potential for major complications. Anesthesiologists should familiarize themselves with high epidural block techniques.http://dx.doi.org/10.1155/2017/7024924 |
| spellingShingle | Manuel Wenk Christina Massoth Daniel M. Pöpping Michael Möllmann Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery Anesthesiology Research and Practice |
| title | Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery |
| title_full | Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery |
| title_fullStr | Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery |
| title_full_unstemmed | Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery |
| title_short | Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery |
| title_sort | feasibility of cervical epidural anesthesia for breast cancer surgery |
| url | http://dx.doi.org/10.1155/2017/7024924 |
| work_keys_str_mv | AT manuelwenk feasibilityofcervicalepiduralanesthesiaforbreastcancersurgery AT christinamassoth feasibilityofcervicalepiduralanesthesiaforbreastcancersurgery AT danielmpopping feasibilityofcervicalepiduralanesthesiaforbreastcancersurgery AT michaelmollmann feasibilityofcervicalepiduralanesthesiaforbreastcancersurgery |