Quality of postoperative recovery after breast surgery. General anaesthesia combined with paravertebral versus serratus-intercostal block.
BACKGROUND
The quality of postoperative recovery is one of the most important among all the quality indicators used in clinical situations. This is even more important after cancer surgery. Our aim was to evaluate this after non-reconstructive breast surgery under general anesthesia and paravertebral blockade or serratus-intercostal plane blockade, in the early and late post-operative period.


METHODS
A prospective observational study was conducted on 60 patients (25 paravertebral blockade group and 35 serratus-intercostal plane blockade group) scheduled for non-reconstructive breast surgery during a 6 month period. Every patient received general anaesthesia and were randomised to receive either paravertebral blockade or serratus-intercostal plane blockade. The quality of post-anaesthetic recovery was quantified by Postoperative Quality Recovery Scale, which is used to assess physiological, nociceptive, emotional, autonomy, cognitive and general state domains at different times: baseline (before surgery), 15min after the end of surgery, at discharge to home, and one month after surgery.


RESULTS
A total recovery of 95.93% was achieved in the early postoperative period (15min PACU), 99.07% at discharge to home, and 99.25% at one month after the intervention. No significant differences were found between groups in total score or in each evaluated area.


CONCLUSIONS
A progressive improvement was observed in the scores assessed with the Postoperative Quality Recovery Scale, reaching values that would allow the discharge to home and early return to usual active life from the immediate postoperative period, with no significant differences between the 2 analgesic techniques. Savings in opioid use and the excellent recovery were observed in all measured domains observed.
Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: mapeherrero@gmail.com.
M A
MA
Pérez Herrero
Complejo Hospitalario Universitario de A Coruña, A Coruña, España.
S
S
López Álvarez
Hospital Clínico Universitario de Valladolid, Valladolid, España.
A
A
Fadrique Fuentes
Hospital Clínico Universitario de Valladolid, Valladolid, España.
F
F
Manzano Lorefice
Hospital Clínico Universitario de Valladolid, Valladolid, España.
C
C
Bartolomé Bartolomé
Hospital Clínico Universitario de Valladolid, Valladolid, España.
J
J
González de Zárate
D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain; D011446:Prospective Studies
Anestesia general; Anestesia regional; Breast cancer surgery; Cirugía de cáncer de mama; General anaesthesia; Gestión de calidad total; Postoperative recovery; Recuperación postanestésica; Regional anaesthesia; Total quality management