Anesthetic technique improves quality of recovery for women having breast cancer surgery

Anesthesiologists using a technique similar to a dental freeze can improve the quality of recovery and decrease recovery time for breast cancer surgery patients, according to a new study.The study, from researchers at St. Michael’s Hospital and Women’s College Hospital, was published in the March edition of Anesthesiology. It is the world’s first randomized control trial for breast cancer surgery that compares the use of ultrasound-guided paravertebral blocks – a local anesthetic freezing that blocks breast nerves – to general anesthetic. The findings reveal that breast cancer patients who received local anesthetic had superior pain relief, spent less time in recovery rooms after surgery, and were discharged an hour earlier than patients who were put under general anesthesia.”Real time, image-guided ultrasound nerve blocks have revolutionized the practice of regional anesthesia,” said Dr. Faraj Abdallah, an anesthesiologist at St. Michael’s Hospital and lead author of the study. “This is the first study to show how effective these ultrasound-guided blocks can now be for breast cancer surgery. Even more importantly, we’ve been able to demonstrate that blocks help patients feel better and return to their normal levels of mental and physical functionality sooner after surgery.”Dr. Abdallah conducted this randomized controlled trial of 64 women at Women’s College Hospital, the first Canadian site to complete a study where this image-guided technique was used in breast cancer surgery. Because of its demonstrated benefits and the addition of Dr. …

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Women in labor can ditch ice chips, drink protein shake instead

Oct. 13, 2013 — Women in labor can enjoy a chocolate or vanilla protein shake during labor rather than being relegated to the tedium of ice chips, according to a study presented at the ANESTHESIOLOGY™ 2013 annual meeting. Mothers who drank a protein drink during childbirth reported higher satisfaction rates, although nausea and vomiting rates were the same as for mothers who were only given ice chips.”Giving birth is a tremendous stress on both mother and baby,” said Manuel C. Vallejo, M.D., D.M.D., professor and chair of the Department of Anesthesiology, West Virginia University School of Medicine, Morgantown. “Anything we can do to increase patient satisfaction during labor without increasing adverse events is a major positive. Physicians should feel comfortable replacing ice chips or water with a high-protein drink supplement.”Nausea and vomiting is an unfortunate side effect for some women in childbirth. Restrictions on eating and drinking during childbirth began more than 50 years ago when women often gave birth under general anesthesia. The risk of aspiration of food and drink into the lungs is a rare but potentially fatal complication of general anesthesia and therefore, women in labor generally have their eating and drinking restricted.In the study, 150 women were split into two groups. The first group received a 325 mL, 160 calorie Premier Nutrition Protein Shake, which contained 30 grams of protein, one gram of sugar, eight amino acids and 24 vitamins and minerals, in addition to ice chips and water. The second group served as the control and only received the ice chips and water. …

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Botox injections reduce chronic neck and cervical muscle pain

Oct. 13, 2012 — A study presented at the Anesthesiology 2012™ annual meeting revealed Botulinum toxin type A (BOTOX) injections significantly improve pain and quality of life in people with chronic bilateral posterior neck and shoulder myofascial pain syndrome.

Traditional therapies for the treatment of myofascial pain syndrome include medications such as anti-inflammatory drugs (such as ibuprofen or naproxen), steroids and muscle relaxants, physical therapy and behavioral modification.

“At best, long-term benefit with traditional therapies is transient and unpredictable,” said Andrea L. Nicol, M.D., M.S., Director of Research — UCLA Pain Management Center, Assistant Clinical Professor, Department of Anesthesiology — Division of Pain Management, David Geffen School of Medicine at UCLA. “Even with these treatments, some people with myofascial pain syndrome get incomplete benefit or no benefit at all.”

BOTOX is used commercially to treat multiple painful medical conditions, including migraine headaches, spasticity and cervical dystonia. It is also used cosmetically as a means of reducing the appearance of frown lines and wrinkles.

“BOTOX is in a class of medications called neurotoxins and when injected into muscles, blocks the nerve signals that cause the tightening of muscle, leading to muscle relaxation. Thus, BOTOX may offer advantages over traditional therapies for myofascial pain syndrome due to its prolonged and sustained effects,” Dr. Nicol confirmed.

About the Study

The study was conducted at the University of California, Los Angeles by Chronic Pain Management Specialists F. Michael Ferrante, M.D. and Andrea Nicol, M.D. All subjects who enrolled in the study were given injections of BOTOX into the painful muscles of the neck and shoulder area during the first phase of the study. Subjects with significant improvement to BOTOX treatment moved on to the second phase of the study and were randomized into two groups. Subjects in the treatment group had BOTOX injections into the painful muscles of the neck and shoulder area. Subjects in the control group received a placebo injection (salt water) into the painful muscles of the neck and shoulder.

Those enrolled in the study were monitored intermittently to assess their response to the injections. Pain scales and questionnaires were administered to document response and perform data analysis.

Analysis of the results revealed subjects who received BOTOX injections had:

A significantly greater reduction of their pain scores compared to those subjects who had received placebo injections.
A significant reduction in the number of headaches they experienced on a weekly basis.
The severity of the subjects’ headaches (numerical pain score rating) was reduced.

A significant reduction in the interference of their pain with regards to general activity, sleep and enjoyment, indicating an overall improved quality of life.

Given the findings of this study, BOTOX may be an option for those who have been suffering with myofascial pain syndrome and have yet to find relief with traditional therapies.

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