Skip to Main content Skip to Navigation
Master Thesis

Le bloc paravertébral curatif des syndromes douloureux post mastectomie : mythe ou réalité ? Une analyse observationnelle prospective de l'efficacité du BPV sur la douleur et la qualité de vie de patientes souffrant de SDPM réfractaires

Abstract : Post-Mastectomy Pain Syndromes (PMPS) are chronic pain conditions that afflict more than one-third of mammary neoplasia patients post-operatively. Ranging in pain intensity, they can significantly alter the quality of life of the women concerned. The hypothesis of this work is that a paravertebral block (PVB) can be used for curative purposes, in addition to the usual therapies, in order to offer long-term relief for patients suffering from refractory PMPS. Through this prospective observational analysis, we performed eleven PVBs over a period of fourteen months on eight women, followed at the Bergonié Institute in Bordeaux (France). They were hospitalised and had a catheter installed at the level of the paravertebral space corresponding to the location of their pain, under ultrasound control. This was used to administer an effective amount of local anesthetic agent (one-third of Xylocaine° to 2% and two-third of Naropeine° to 0,75%) followed by a continuous flow of Naropeine° to 0,2% for five days by a GEMSTAR° pump. The flow rate was regularly adjusted to the women's analgesia. Data was collected before the procedure and one month later, by a validated questionnaire. We obtained significant relief (an intensity less than or equal to 4 on the Numeric Rating Scale) still present one month following the procedure for 81.8% of the PVBs performed (9/11), with an average pain relief of 60.5%. There were no significant adverse reactions. The quality of life was improved for all women. The results are therefore interesting, despite the small scale of the study, and make it possible to propose this procedure to patients suffering from moderate to severe refractory PMPS, with an acceptable risk-benefit balance.
Document type :
Master Thesis
Complete list of metadatas

Cited literature [85 references]  Display  Hide  Download

https://dumas.ccsd.cnrs.fr/dumas-01636637
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, November 16, 2017 - 5:56:28 PM
Last modification on : Thursday, December 7, 2017 - 1:16:13 AM
Long-term archiving on: : Saturday, February 17, 2018 - 4:56:37 PM

File

Med_generale_2017Pourtales.pdf
Files produced by the author(s)

Identifiers

  • HAL Id : dumas-01636637, version 1

Collections

Citation

Audrey Pourtales. Le bloc paravertébral curatif des syndromes douloureux post mastectomie : mythe ou réalité ? Une analyse observationnelle prospective de l'efficacité du BPV sur la douleur et la qualité de vie de patientes souffrant de SDPM réfractaires . Médecine humaine et pathologie. 2017. ⟨dumas-01636637⟩

Share

Metrics

Record views

104

Files downloads

118