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Horner's SD After Thoracic Epidural Block

Completed
Conditions
Horner's Syndrome
Interventions
Procedure: thoracic epidural anesthesia
Procedure: mastectomy
Registration Number
NCT02130739
Lead Sponsor
Soonchunhyang University Hospital
Brief Summary

This study prospectively evaluates the incidence of Horner's syndrome after thoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy. The incidence was 1.36% and the mechanism of Horner's syndrome was cephalic spread of the local anesthetic.

Detailed Description

Transient Horner's syndrome has been recognized rare complication of epidural anesthesia and the incidence is not exactly well-known in thoracic epidural anesthesia. Therefore, this study prospectively evaluates the incidence of Horner's syndrome after thoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy.

Six hundred thirty three Patients, who scheduled for mastectomy with/without breast reconstruction, were eligible for this prospective observational study from September 2010 to December 2013. Thoracic epidural anesthesia performed using 0.375% or 0.5% ropivacaine 15mL followed by sedation consisting of propofol without muscle relaxation. After the operation, thoracic epidural analgesia continued; supplemented by a continuous epidural infusion of ropivacaine 0.15%, 2 ml/h with fentanyl 8mcg/h. At 1 hour, 2hour, 1 day, 2 day and 3 day after the operation, postoperative surveillance consisted of the occurrence of symptoms of Horner's syndrome (miosis, ptosis, and hyperemia) were performed by anesthesiologists.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
450
Inclusion Criteria
  • Patients, who scheduled for mastectomy with/without breast reconstruction
Exclusion Criteria
  • The patients who had more than one abnormal preoperative clotting parameter either clinical signs of potential bleeding disorders suggested by bruising
  • Petechiae, or ecchymosis, or anatomic or neurologic abnormalities
  • That is, significant scoliosis or kyphosis, radyculopathy or ptosis
  • Unsuccessful catheter placement (impossible to insert a catheter at two vertebral levels)
  • Unsuccessful epidural anesthesia (not checkable sensory block)
  • Dural perforation or intravascular catheterization

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
thoracic epidural anesthesiathoracic epidural anesthesiathoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy
thoracic epidural anesthesiamastectomythoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy
thoracic epidural anesthesiaRopivacainethoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy
thoracic epidural anesthesiaPropofolthoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy
thoracic epidural anesthesiaFentanylthoracic epidural anesthesia following continuous thoracic epidural analgesia for mastectomy
Primary Outcome Measures
NameTimeMethod
Number of Participants with Horner's syndrome3 day after the operation
Secondary Outcome Measures
NameTimeMethod
Number of Participants with back pain3 day after the operation
Number of Participants with radiating symptoms3 day after the operation

segmental pain or paresthesia corresponded to a dermatome of epidural block spinal root

Number of Participants with numbness3 day after the operation
Number of Participants with muscular weakness3 day after the operation

Trial Locations

Locations (1)

Soonchunhyang University Seoul Hospital

🇰🇷

Seoul, Korea, Republic of

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