ASA: Paravertebral Block Ups Breast Cancer Surgery Outcomes
(HealthDay News) – For patients undergoing breast cancer surgery, paravertebral block combined with general anesthesia is associated with decreased local and metastatic recurrence and lower breast cancer-related mortality, according to a study presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 12–16 in San Francisco.
To examine whether paravertebral block combined with general anesthesia reduces the risk of breast cancer compared with general anesthesia alone, Asser M. Oppfeldt, MD, and Palle S. Carlsson, MD, PhD, from the Aarhus University Hospital in Denmark, conducted a follow-up study to a randomized controlled trial. Participants having breast cancer surgery with standardized anesthesia were randomized to receive four to six paravertebral injections of ropivacaine (39 patients) or saline (38 patients).
After six or more years, the researchers found that local or metastatic recurrence occurred in 13% of the ropivacaine group and in 37% of the saline group (risk ratio, 0.35; P=0.024). Breast cancer-related mortality was significantly lower in the ropivacaine vs. the saline group (risk ratio, 0.32). Opioid consumption was significantly lower for patients without cancer recurrence vs. those with recurrence (P=0.016).
"It has been theorized that the long-term effect of anesthetic method, drugs used, and the pain therapy applied after surgery can influence how the disease progresses – whether the cancer comes back or the patient dies," Carlsson said in a statement.