The efficacy of norepinephrine application in Mammotome-assisted minimally invasive resection for benign breast neoplasm: A retrospective study

BMC Surg. 2024 Dec 19;24(1):393. doi: 10.1186/s12893-024-02701-y.

Abstract

Objective: Although Mammotome-assisted minimally invasive resection (MAMIR) has been widely accepted for treating breast benign nodules, the procedure remains very technical and challenging. The present study aimed to assess the efficacy of norepinephrine application in MAMIR concerning intraoperative hemorrhage, postoperative pain and postoperative hospitalization.

Methods: A total of 306 patients with breast nodules admitted at the Xishan people's Hospital of Wuxi City between June 2021 and July 2023 were included in this retrospective cohort study. The patient's age, comorbidities (hypertension and diabetes), and characteristics of the breast nodule (number, unilateral or bilateral nature, inner quadrant volume and total volume) were all meticulously documented. Operation time, intraoperative hemorrhage, postoperative hospitalization and Visual analogue scale(VAS) score (postoperative 6-hour pain score) were recorded. Based on the application of norepinephrine, patients were categorized into non-NPP(norepinephrine) and NPP group. Univariate and multivariate analyses were performed to estimate the odds ratio (OR) and the 95% confidence intervals (CIs) for outcomes.

Results: A total of 155 who accepted MAMIR were included in this study. The NPP group exhibited reduced intraoperative bleeding, diminished postoperative pain, and a shorter duration of hospitalization (p < 0.05). Univariable analysis indicated that usage of norepinephrine during operation helped to reduce intraoperative hemorrhage (OR = 0.14, 95%CI: 0.07-0.31), alleviate postoperative pain(OR = 0.03, 95%CI: 0.01-0.09) and shorten hospital stay(OR = 0.50, 95%CI: 0.26-0.95). Furthermore, multivariate analysis identified the usage of norepinephrine during MAMIR as an independent factor associated with reducing intraoperative hemorrhage (OR = 0.11, 95%CI: 0.05-0.26) and relieving postoperative pain (OR = 0.02, 95%CI: 0.004-0.08) after adjusting for other factories.

Conclusions: Norepinephrine could help to reduce postoperative hospitalization and intraoperative hemorrhage, also relieve postoperative pain for breast benign nodules resection, which was an independent protective factor for relieving postoperative pain and reducing intraoperative hemorrhage.

Keywords: Breast nodules; Mammotome; Minimally invasive surgery; Norepinephrine; Retrospective study.

MeSH terms

  • Adult
  • Aged
  • Blood Loss, Surgical / prevention & control
  • Blood Loss, Surgical / statistics & numerical data
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Middle Aged
  • Minimally Invasive Surgical Procedures* / methods
  • Norepinephrine* / administration & dosage
  • Norepinephrine* / therapeutic use
  • Pain Measurement
  • Pain, Postoperative* / diagnosis
  • Pain, Postoperative* / drug therapy
  • Pain, Postoperative* / etiology
  • Pain, Postoperative* / prevention & control
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Norepinephrine