Comparative Study of Liposomal Bupivacaine Versus Paravertebral Block for Pain Control Following Mastectomy with Immediate Tissue Expander Reconstruction
Background Several approaches to minimize postoperative pain, nausea, and enhance recovery are available for patients undergoing mastectomy with immediate tissue expander (TE) reconstruction. We compared the effectiveness of intraoperative local infiltration of liposomal bupivacaine (LB) to preopera...
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| Veröffentlicht in: | Annals of surgical oncology 2016-02, Vol.23 (2), p.465-470 |
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| creator | Abdelsattar, Jad M. Boughey, Judy C. Fahy, Aodhnait S. Jakub, James W. Farley, David R. Hieken, Tina J. Degnim, Amy C. Goede, Whitney Mohan, Anita T. Harmsen, William S. Niesen, Adam D. Tran, Nho V. Bakri, Karim Jacobson, Steven R. Lemaine, Valerie Saint-Cyr, Michel |
| description | Background
Several approaches to minimize postoperative pain, nausea, and enhance recovery are available for patients undergoing mastectomy with immediate tissue expander (TE) reconstruction. We compared the effectiveness of intraoperative local infiltration of liposomal bupivacaine (LB) to preoperative paravertebral block (PVB).
Methods
We retrospectively reviewed patients who underwent mastectomy with immediate TE reconstruction between May 2012 and October 2014 and compared patients with preoperative ultrasound-guided PVB to those with intraoperative LB infiltration.
Results
Fifty-three patients (54.6 %) received LB and 44 received PVB. LB was associated with less opioid use in the recovery room (
p
|
| doi_str_mv | 10.1245/s10434-015-4833-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1760931092</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1760931092</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-be16a31dcc8af1e5ecde340b09b2a9813669b4c9480581c429733d3fb719ec743</originalsourceid><addsrcrecordid>eNp1kctu1DAUhiMEoqXwAGyQJTZsAr4lsZcwammlQSBou7Uc56S4JHbqy5R5lL5tPZqCEFJXPjr-_PvofFX1muD3hPLmQySYM15j0tRcMFbzJ9UhaUqHt4I8LTVuRS1p2xxUL2K8xph0DDfPqwPaMtxRRg-ru5WfFx10shtAP1IetsiPaG0XH_2sJ_QpL3ajjbYO0CWEmCP6VvANhAR92AGTN7_Q6EPpW4dW3qXgJ3Tip8nfWneFvuiYwCQ_b9GtTT_R2TzDYHUCdG5jzICOfy_aDRDQdzDexRSySda7l9WzUU8RXj2cR9XFyfH56rRef_18tvq4rg3nNNU9kFYzMhgj9EigATMA47jHsqdaCsLaVvbcSC5wI4jhVHaMDWzsOyLBdJwdVe_2uUvwNxliUrONBqZJO_A5KtK1WDKCJS3o2__Qa5-DK9MVqhFYYipkocieMsHHGGBUS7CzDltFsNp5U3tvqnhTO29qN8Sbh-Tcl_X8ffFHVAHoHojlyl1B-OfrR1PvAa1opZw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1758090289</pqid></control><display><type>article</type><title>Comparative Study of Liposomal Bupivacaine Versus Paravertebral Block for Pain Control Following Mastectomy with Immediate Tissue Expander Reconstruction</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Abdelsattar, Jad M. ; Boughey, Judy C. ; Fahy, Aodhnait S. ; Jakub, James W. ; Farley, David R. ; Hieken, Tina J. ; Degnim, Amy C. ; Goede, Whitney ; Mohan, Anita T. ; Harmsen, William S. ; Niesen, Adam D. ; Tran, Nho V. ; Bakri, Karim ; Jacobson, Steven R. ; Lemaine, Valerie ; Saint-Cyr, Michel</creator><creatorcontrib>Abdelsattar, Jad M. ; Boughey, Judy C. ; Fahy, Aodhnait S. ; Jakub, James W. ; Farley, David R. ; Hieken, Tina J. ; Degnim, Amy C. ; Goede, Whitney ; Mohan, Anita T. ; Harmsen, William S. ; Niesen, Adam D. ; Tran, Nho V. ; Bakri, Karim ; Jacobson, Steven R. ; Lemaine, Valerie ; Saint-Cyr, Michel</creatorcontrib><description>Background
Several approaches to minimize postoperative pain, nausea, and enhance recovery are available for patients undergoing mastectomy with immediate tissue expander (TE) reconstruction. We compared the effectiveness of intraoperative local infiltration of liposomal bupivacaine (LB) to preoperative paravertebral block (PVB).
Methods
We retrospectively reviewed patients who underwent mastectomy with immediate TE reconstruction between May 2012 and October 2014 and compared patients with preoperative ultrasound-guided PVB to those with intraoperative LB infiltration.
Results
Fifty-three patients (54.6 %) received LB and 44 received PVB. LB was associated with less opioid use in the recovery room (
p
< 0.001), fewer patients requiring antiemetics (
p
= 0.03), and lower day of surgery pain scores (
p
= 0.008). LB also was associated with longer time to first opioid use (
p
= 0.04). On multivariable analysis controlling for expander placement location, year of surgery, and axillary lymph node dissection (ALND), the only variable that remained statistically significant was lower opioid use in the recovery room for patients with LB (
p
= 0.03) and day of surgery pain scores approached significance (
p
= 0.05). There was no difference in the proportion of patients discharged within 36 h of surgery between the groups. Focusing on first cases of the day (where PVBs are performed in the OR) showed average time to skin incision was 15 min shorter in the LB group (
p
= 0.004).
Conclusions
Local infiltration of LB in patients undergoing mastectomy with immediate TE reconstruction decreases narcotic requirements in the recovery room, shortens preoperative anesthesiology time, and provides similar, if not better, perioperative pain control compared with PVB.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-015-4833-4</identifier><identifier>PMID: 26307232</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anesthetics, Local - administration & dosage ; Breast Implants ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Breast Oncology ; Bupivacaine - administration & dosage ; Female ; Follow-Up Studies ; Humans ; Liposomes - administration & dosage ; Mammaplasty - instrumentation ; Mammaplasty - methods ; Mastectomy - adverse effects ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Nerve Block - methods ; Oncology ; Pain Management ; Pain, Postoperative - prevention & control ; Prognosis ; Retrospective Studies ; Surgery ; Surgical Oncology ; Tissue Expansion Devices ; Young Adult</subject><ispartof>Annals of surgical oncology, 2016-02, Vol.23 (2), p.465-470</ispartof><rights>Society of Surgical Oncology 2015</rights><rights>Society of Surgical Oncology 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-be16a31dcc8af1e5ecde340b09b2a9813669b4c9480581c429733d3fb719ec743</citedby><cites>FETCH-LOGICAL-c442t-be16a31dcc8af1e5ecde340b09b2a9813669b4c9480581c429733d3fb719ec743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-015-4833-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-015-4833-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26307232$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abdelsattar, Jad M.</creatorcontrib><creatorcontrib>Boughey, Judy C.</creatorcontrib><creatorcontrib>Fahy, Aodhnait S.</creatorcontrib><creatorcontrib>Jakub, James W.</creatorcontrib><creatorcontrib>Farley, David R.</creatorcontrib><creatorcontrib>Hieken, Tina J.</creatorcontrib><creatorcontrib>Degnim, Amy C.</creatorcontrib><creatorcontrib>Goede, Whitney</creatorcontrib><creatorcontrib>Mohan, Anita T.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Niesen, Adam D.</creatorcontrib><creatorcontrib>Tran, Nho V.</creatorcontrib><creatorcontrib>Bakri, Karim</creatorcontrib><creatorcontrib>Jacobson, Steven R.</creatorcontrib><creatorcontrib>Lemaine, Valerie</creatorcontrib><creatorcontrib>Saint-Cyr, Michel</creatorcontrib><title>Comparative Study of Liposomal Bupivacaine Versus Paravertebral Block for Pain Control Following Mastectomy with Immediate Tissue Expander Reconstruction</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Several approaches to minimize postoperative pain, nausea, and enhance recovery are available for patients undergoing mastectomy with immediate tissue expander (TE) reconstruction. We compared the effectiveness of intraoperative local infiltration of liposomal bupivacaine (LB) to preoperative paravertebral block (PVB).
Methods
We retrospectively reviewed patients who underwent mastectomy with immediate TE reconstruction between May 2012 and October 2014 and compared patients with preoperative ultrasound-guided PVB to those with intraoperative LB infiltration.
Results
Fifty-three patients (54.6 %) received LB and 44 received PVB. LB was associated with less opioid use in the recovery room (
p
< 0.001), fewer patients requiring antiemetics (
p
= 0.03), and lower day of surgery pain scores (
p
= 0.008). LB also was associated with longer time to first opioid use (
p
= 0.04). On multivariable analysis controlling for expander placement location, year of surgery, and axillary lymph node dissection (ALND), the only variable that remained statistically significant was lower opioid use in the recovery room for patients with LB (
p
= 0.03) and day of surgery pain scores approached significance (
p
= 0.05). There was no difference in the proportion of patients discharged within 36 h of surgery between the groups. Focusing on first cases of the day (where PVBs are performed in the OR) showed average time to skin incision was 15 min shorter in the LB group (
p
= 0.004).
Conclusions
Local infiltration of LB in patients undergoing mastectomy with immediate TE reconstruction decreases narcotic requirements in the recovery room, shortens preoperative anesthesiology time, and provides similar, if not better, perioperative pain control compared with PVB.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Breast Implants</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast Oncology</subject><subject>Bupivacaine - administration & dosage</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Liposomes - administration & dosage</subject><subject>Mammaplasty - instrumentation</subject><subject>Mammaplasty - methods</subject><subject>Mastectomy - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Nerve Block - methods</subject><subject>Oncology</subject><subject>Pain Management</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Tissue Expansion Devices</subject><subject>Young Adult</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kctu1DAUhiMEoqXwAGyQJTZsAr4lsZcwammlQSBou7Uc56S4JHbqy5R5lL5tPZqCEFJXPjr-_PvofFX1muD3hPLmQySYM15j0tRcMFbzJ9UhaUqHt4I8LTVuRS1p2xxUL2K8xph0DDfPqwPaMtxRRg-ru5WfFx10shtAP1IetsiPaG0XH_2sJ_QpL3ajjbYO0CWEmCP6VvANhAR92AGTN7_Q6EPpW4dW3qXgJ3Tip8nfWneFvuiYwCQ_b9GtTT_R2TzDYHUCdG5jzICOfy_aDRDQdzDexRSySda7l9WzUU8RXj2cR9XFyfH56rRef_18tvq4rg3nNNU9kFYzMhgj9EigATMA47jHsqdaCsLaVvbcSC5wI4jhVHaMDWzsOyLBdJwdVe_2uUvwNxliUrONBqZJO_A5KtK1WDKCJS3o2__Qa5-DK9MVqhFYYipkocieMsHHGGBUS7CzDltFsNp5U3tvqnhTO29qN8Sbh-Tcl_X8ffFHVAHoHojlyl1B-OfrR1PvAa1opZw</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Abdelsattar, Jad M.</creator><creator>Boughey, Judy C.</creator><creator>Fahy, Aodhnait S.</creator><creator>Jakub, James W.</creator><creator>Farley, David R.</creator><creator>Hieken, Tina J.</creator><creator>Degnim, Amy C.</creator><creator>Goede, Whitney</creator><creator>Mohan, Anita T.</creator><creator>Harmsen, William S.</creator><creator>Niesen, Adam D.</creator><creator>Tran, Nho V.</creator><creator>Bakri, Karim</creator><creator>Jacobson, Steven R.</creator><creator>Lemaine, Valerie</creator><creator>Saint-Cyr, Michel</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160201</creationdate><title>Comparative Study of Liposomal Bupivacaine Versus Paravertebral Block for Pain Control Following Mastectomy with Immediate Tissue Expander Reconstruction</title><author>Abdelsattar, Jad M. ; Boughey, Judy C. ; Fahy, Aodhnait S. ; Jakub, James W. ; Farley, David R. ; Hieken, Tina J. ; Degnim, Amy C. ; Goede, Whitney ; Mohan, Anita T. ; Harmsen, William S. ; Niesen, Adam D. ; Tran, Nho V. ; Bakri, Karim ; Jacobson, Steven R. ; Lemaine, Valerie ; Saint-Cyr, Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-be16a31dcc8af1e5ecde340b09b2a9813669b4c9480581c429733d3fb719ec743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Breast Implants</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast Oncology</topic><topic>Bupivacaine - administration & dosage</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Liposomes - administration & dosage</topic><topic>Mammaplasty - instrumentation</topic><topic>Mammaplasty - methods</topic><topic>Mastectomy - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Nerve Block - methods</topic><topic>Oncology</topic><topic>Pain Management</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Tissue Expansion Devices</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abdelsattar, Jad M.</creatorcontrib><creatorcontrib>Boughey, Judy C.</creatorcontrib><creatorcontrib>Fahy, Aodhnait S.</creatorcontrib><creatorcontrib>Jakub, James W.</creatorcontrib><creatorcontrib>Farley, David R.</creatorcontrib><creatorcontrib>Hieken, Tina J.</creatorcontrib><creatorcontrib>Degnim, Amy C.</creatorcontrib><creatorcontrib>Goede, Whitney</creatorcontrib><creatorcontrib>Mohan, Anita T.</creatorcontrib><creatorcontrib>Harmsen, William S.</creatorcontrib><creatorcontrib>Niesen, Adam D.</creatorcontrib><creatorcontrib>Tran, Nho V.</creatorcontrib><creatorcontrib>Bakri, Karim</creatorcontrib><creatorcontrib>Jacobson, Steven R.</creatorcontrib><creatorcontrib>Lemaine, Valerie</creatorcontrib><creatorcontrib>Saint-Cyr, Michel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abdelsattar, Jad M.</au><au>Boughey, Judy C.</au><au>Fahy, Aodhnait S.</au><au>Jakub, James W.</au><au>Farley, David R.</au><au>Hieken, Tina J.</au><au>Degnim, Amy C.</au><au>Goede, Whitney</au><au>Mohan, Anita T.</au><au>Harmsen, William S.</au><au>Niesen, Adam D.</au><au>Tran, Nho V.</au><au>Bakri, Karim</au><au>Jacobson, Steven R.</au><au>Lemaine, Valerie</au><au>Saint-Cyr, Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative Study of Liposomal Bupivacaine Versus Paravertebral Block for Pain Control Following Mastectomy with Immediate Tissue Expander Reconstruction</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>23</volume><issue>2</issue><spage>465</spage><epage>470</epage><pages>465-470</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Several approaches to minimize postoperative pain, nausea, and enhance recovery are available for patients undergoing mastectomy with immediate tissue expander (TE) reconstruction. We compared the effectiveness of intraoperative local infiltration of liposomal bupivacaine (LB) to preoperative paravertebral block (PVB).
Methods
We retrospectively reviewed patients who underwent mastectomy with immediate TE reconstruction between May 2012 and October 2014 and compared patients with preoperative ultrasound-guided PVB to those with intraoperative LB infiltration.
Results
Fifty-three patients (54.6 %) received LB and 44 received PVB. LB was associated with less opioid use in the recovery room (
p
< 0.001), fewer patients requiring antiemetics (
p
= 0.03), and lower day of surgery pain scores (
p
= 0.008). LB also was associated with longer time to first opioid use (
p
= 0.04). On multivariable analysis controlling for expander placement location, year of surgery, and axillary lymph node dissection (ALND), the only variable that remained statistically significant was lower opioid use in the recovery room for patients with LB (
p
= 0.03) and day of surgery pain scores approached significance (
p
= 0.05). There was no difference in the proportion of patients discharged within 36 h of surgery between the groups. Focusing on first cases of the day (where PVBs are performed in the OR) showed average time to skin incision was 15 min shorter in the LB group (
p
= 0.004).
Conclusions
Local infiltration of LB in patients undergoing mastectomy with immediate TE reconstruction decreases narcotic requirements in the recovery room, shortens preoperative anesthesiology time, and provides similar, if not better, perioperative pain control compared with PVB.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26307232</pmid><doi>10.1245/s10434-015-4833-4</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2016-02, Vol.23 (2), p.465-470 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1760931092 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Anesthetics, Local - administration & dosage Breast Implants Breast Neoplasms - pathology Breast Neoplasms - surgery Breast Oncology Bupivacaine - administration & dosage Female Follow-Up Studies Humans Liposomes - administration & dosage Mammaplasty - instrumentation Mammaplasty - methods Mastectomy - adverse effects Medicine Medicine & Public Health Middle Aged Neoplasm Staging Nerve Block - methods Oncology Pain Management Pain, Postoperative - prevention & control Prognosis Retrospective Studies Surgery Surgical Oncology Tissue Expansion Devices Young Adult |
| title | Comparative Study of Liposomal Bupivacaine Versus Paravertebral Block for Pain Control Following Mastectomy with Immediate Tissue Expander Reconstruction |
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