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All Journal Jurnal Anestesiologi Indonesia Jurnal Anestesi Perioperatif Medula Jurnal Kesehatan Andalas Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Indonesian Journal of Anesthesiology and Reanimation (IJAR) Indonesian Journal of Global Health research Journal of Anaesthesia and Pain Narra J Jurnal Neuroanestesi Indonesia Majalah Anestesia & Critical Care (MACC) The Journal of Society Medicine (JSOCMED) Jurnal Pengabdian Pada Masyarakat METHABDI Jurnal Kesehatan Mahardika
Hamdi, Tasrif
Unknown Affiliation
Religion Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Physics Public Health

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Journal : Narra J

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Effectiveness and safety of thoracic segmental spinal anesthesia for breast surgery: A systematic review and meta-analysis Hamdi, Tasrif; Mastari, Ekawaty S.; Lubis, Andriamuri P.; Ghozali, Imam; Kemalasari, Nadia; Harahap, Awi TM.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1630

Abstract

General anesthesia is the standard approach for thoracic and abdominal procedures; however, it has notable limitations, particularly in high-risk patients. Regional anesthesia techniques, such as thoracic segmental spinal anesthesia, have gained popularity due to their potential to reduce these associated risks. The aim of this study was to assess the effectiveness and safety of thoracic segmental spinal anesthesia in breast cancer surgery using systematic review and meta-analysis. This study adhered to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines, conducting a comprehensive literature search across ScienceDirect, Cochrane Library, and PubMed databases up to July 4, 2024. The inclusion criteria focused on studies that provided specific information on the effectiveness (postoperative pain reduction) and safety (incidence of adverse events and complications) of thoracic segmental spinal anesthesia, as well as satisfaction among patients and surgeons. Out of 4,060 articles, six studies were included for qualitative assessment, with four further analyzed quantitatively. Meta-analysis findings indicated that thoracic segmental spinal anesthesia provided significantly better pain control at 12 hours postoperatively (SMD: -1.25; 95%CI: -1.54 to -0.96; p<0.0001), although no significant difference was noted at 0 hours (SMD: -1.07; 95%CI: -2.33 to 0.18; p=0.09). Thoracic segmental spinal anesthesia was associated with a lower incidence of postoperative vomiting (RR: 0.46; 95%CI: 0.22–0.95; p=0.04), but it presented a higher risk of hypotension (RR: 2.57; 95%CI: 1.41–4.71; p=0.002). Importantly, no anesthesia-related mortalities were reported. The technique resulted in higher satisfaction levels among both patients (SMD: 0.63; 95%CI: 0.33–0.92; p<0.0001) and surgeons (SMD: 0.81; 95%CI: 0.51–1.11; p<0.0001) compared to general anesthesia. The study highlights that thoracic segmental spinal anesthesia is a safe and effective alternative to general anesthesia for breast cancer surgery, offering superior postoperative pain control, enhanced patient and surgeon satisfaction, and a reduced incidence of postoperative vomiting.
Co-Authors Akim, Mhd Albar, Husnul Fuad Ayu Assyifa Hamka Dinata Bangun, Chrismas Gideon Bisono, Luwih Chalil, M. Jalaluddin A. Chandra, Nopial Ade Christine Christine Diani Nazma Eka Roina Megawati, Eka Roina Endy Juli Anto Fadinie, Wulan Fathia Meirina, Fathia Fithria Aldy Hadyanto Lim Hanafie, Achsanuddin Hanif, Raisa Syifa Hanim, Saodah Harahap, Awi Tifani M Harahap, Awi Tifani Mayandisa Harahap, Awi TM. Harahap, Juliandi Hutasoit, Eka Samuel P. Ihsan, Mhd Ihsan, Mhd. Imam Ghozali Irfan Hamdani, Irfan Irina, Rr Sinta Irina, Sinta Kadri, Alfansuri Kemalasari, Nadia Lubis, Andriamuri P. Lubis, Andriamuri Primaputra Mastari, Ekawaty S. Muhammad Ihsan Muhammad Ramadhan Munawar, Riza Nadeak, Rommy F. Nasution, Siti Saidah Natalie S., Karen Nurchotijah, Nurchotijah Prabowo, Haryo Pratama, Mhd. Rizki Putri Chairani Eyanoer, Putri Chairani Qadri Fauzi Tanjung Ramud, Samawi Husein Rendi Sidiq Ricardo, Dion Rimbun, Surjadi Rina Amelia Rizone, Alifya Shifwah Saputra, Firdaus Siahaan, Dwi Lunarta D. S. Siahaan, Jekson Martiar Sibarani, Nicholas Hamonangan Silaen, Ester L. R. Silaen, Ester Lantika Simamora, Fareza Rifki Simamora, Veronica Simbolon, Boyke M. Sinaga, Ade Sinaga, Ade Putra Fratama Sinatra, Jadeny Siregar, Ahmad Habibi Sitepu, John Frans Stephanie S., Kezia Tambunan, Ronald T. H. Tanjung, Qodri F. Tarigan, Juliyanti Tobing, Paul S. M. L. Umar, Nazaruddin Wahyuni, Arlinda Sari wicaksono, desmiko haryo YUNAFRI, ANDRI Yunanda, Yuki Yusmaidi, Yusmaidi Zainumi, Cut M. Zainumi, Cut Meliza