Batt Jeremy, Cook Nicola, Nadeem Muhammad, Sahu Ajay
Bristol Breast Care Centre, North Bristol NHS Trust, Westbury-On-Trym, UK.
J Perioper Pract. 2020 Sep;30(9):277-282. doi: 10.1177/1750458920944080.
COVID-19 has changed the approach to operating on breast cancer for the benefit of patients, staff and the general population. One approach involves the switch from operating under general to local anaesthetic. We assess whether diluational local anaesthetic is as effective as the current standard approach.
Postoperative pain was recorded in prospective, consecutive patients undergoing wide local excision under dilutional local anaesthetic (concentration < 1mg/ml). Pain scores were documented at 0, 30 and 60 minutes and compared to a control group consisting of combined general with local anaesthetic.
Pain significantly increased in the control group during the postoperative recovery. This was not seen in the dilutional local anaesthetic group that was non-inferior to the standard approach at 0, 30 and 60 minutes.
Dilutional local anaesthetic provides a safe and effective alternative approach to operating on breast cancer patients whilst avoiding risky general anaesthetic in a COVID-19 pandemic environment.
为了患者、医护人员和普通民众的利益，新冠疫情改变了乳腺癌的手术方式。一种方法是从全身麻醉改为局部麻醉。我们评估稀释局部麻醉是否与当前的标准方法同样有效。
前瞻性地记录连续接受稀释局部麻醉（浓度<1mg/ml）下广泛局部切除手术患者的术后疼痛情况。在0、30和60分钟记录疼痛评分，并与由全身麻醉联合局部麻醉组成的对照组进行比较。
对照组在术后恢复期间疼痛显著增加。在稀释局部麻醉组中未观察到这种情况，该组在0、30和60分钟时并不劣于标准方法。
在新冠疫情环境下，稀释局部麻醉为乳腺癌患者手术提供了一种安全有效的替代方法，同时避免了有风险的全身麻醉。
