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Regional anesthesia and analgesia may maintain immune function, reduce surgical stress, and also reduce volatile anesthetics and opioids requirements. Local anesthetic drugs used in regional anesthesia and analgesia work to have anti-proliferative and cytotoxic effects on cancer cells. Pro-inflammatory cytokines such as IL-1, IL-6, and TNF-alpha increase in levels in peripheral nerves, spinal cord, brain (brain stem, locus sereleus, thalamus, hippocampus, and prefrontal cortex) after peripheral nerves are injured. The anti-inflammatory cytokine IL-10 is decreased in levels after peripheral nerve injury. The balance between pro-inflammatory and anti-inflammatory cytokines affects the severity of pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Paravertebral (Group P) | Patients underwent MRM under the combination of general anesthesia and paravertebral block. |
| |
| General Anesthesia (Group G) | Patients underwent MRM under general anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Paravertebral block | Procedure | The subjects in this group received general anesthesia and USG-guided paravertebral block |
|
| Measure | Description | Time Frame |
|---|---|---|
| Concentration of IL-2 in blood serum | Concentration of IL-2 level in blood serum | 1-hour after surgery |
| Concentration of IL-2 in blood serum | Concentration of IL-2 level in blood serum | 24-hours after surgery |
| Concentration of IL-6 in blood serum | Concentration of IL-6 level in blood serum | 1-hour after surgery |
| Concentration of IL-6 in blood serum | Concentration of IL-6 level in blood serum | 24-hours after surgery |
| Visual Analog Scale (VAS) | pain score measured by visual analog scale (VAS), scaled between 0 (no pain) and 10 (worst pain) | 24-hours after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Concentration of PGE2 level in blood serum | Concentration of PGE2 level in blood serum | 1-hour after surgery |
| Concentration of PGE2 level in blood serum | Concentration of PGE2 level in blood serum |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with breast cancer (stadium Ia-IIIb) who underwent MRM surgery under general anesthesia in Sanglah General Hospital
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sanglah General Hospital | Denpasar | Bali | 80114 | Indonesia |
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| General Anesthesia | Procedure | The subjects in this group underwent MRM under routine general anesthesia without peripheral nerve block supplementation. |
|
| 24-hours after surgery |
| Concentration of MMP-9 level in blood serum | Concentration of MMP-9 level in blood serum | 1-hour after surgery |
| Concentration of MMP-9 level in blood serum | Concentration of MMP-9 level in blood serum | 24-hours after surgery |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D000768 | Anesthesia, General |
| ID | Term |
|---|---|
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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