Modified radical mastectomy under local anasthesia using Tumescent Technique experience of Teaching Hospitals in Iraq
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1
Department of surgery, Medical College, Kufa University, Iraq, Iraq
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Department of surgery, Al-Khadymia Teaching Hospital, Baghdad, Iraq, Iraq
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Department of surgery, AL Najaf Teaching Hospital, Najaf Health Directorate, Iraq, Iraq
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College of medicine, University of Alkafeel, Iraq, Iraq
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Department of surgery, College of medicine, Jabir Ibn Hayyan for medical and pharmaceutical University, Iraq, Iraq
Submission date: 2024-10-15
Acceptance date: 2024-12-10
Publication date: 2025-04-01
Wiadomości Lekarskie 2025;(2):311-315
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ABSTRACT
Aim:
Background: In Western nations, breast cancer is most common cause of death for middle-aged and older women. Aims: to evaluate the advantages, disadvantages, safety, and restrictions of local anaesthetic against general anesthesia for mastectomy.
Material and methods:
Materials and Methods: In this prospective clinical trial, which was carried out at Al-Sader teaching hospital from October 2020 to September 2023, 25 patients (LA group) with a mean age of 64.0±6.3 years (range 55-76 years) underwent a unilateral total mastectomy for breast cancer under local anesthesia using tumescent technique (by manual infiltration technique), and an additional 25 patients (GA group) as a control group with a mean age of 64.9±6.9 years (range 55-75 years) underwent a unilateral mastectomy.
Results:
Results: With use of light sedation for 6 patients, anesthetic is sufficient for all 25 patients. The amount of blood loss intraoperatively measured by number of gauze used during the procedure, approximately 3 gauze, 20 cc of blood for each gauze was significantly lower in LA group than GA group, 2.7±0.4, 5.4±0.4 gauze respectively P<0.001. More than 8 hours after surgery, patients are pain-free. No postoperative complications like necrosis of skin flap, wound infection, or hematoma, when compared to GA group, surgery took substantially longer in LA group 48.9±14.3 minutes than in GA group 38.2±2.9 minutes; P<0.001. The day after the surgery, the patient was discharged.
Conclusions:
Conclusions: The use of tumescent anesthesia (which is safe and effective) is an attractive alternative method for general anesthesia in properly selected candidates (class IV according to American society of anesthesia).