Pectoral block versus thoracic paravertebral block for analgesia in breast surgeries: A prospective randomized study
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 3
Abstract
Background: Breast surgeries are associated with postoperative pain and hence various regional blocks are tried for analgesia. Aims: In this study, we compared the effects of ultrasound-guided pectoral nerve block (PECS) block and thoracic paravertebral (TPVB) block on postoperative opioid consumption, pain scores, and intraoperative fentanyl consumption of patients undergoing unilateral modified radical mastectomy surgery. Setting and Design: This prospective randomized study was conducted in the Department of Anaesthesiology and Critical Care of a tertiary care centre. Methods: 50 patients of ASA physical status I and II of age group 18-65 years undergoing elective modified radical mastectomy under general anesthesia were randomly allocated into two groups using computer generated randomized list. In group 1 patients ultrasound guided pectoral block was performed and in group 2 paravertebral blocks were performed. Intraoperative fentanyl consumption and postoperative pain score (VAS score) were compared between two groups. Time to first rescue analgesia and total morphine requirement in 24 hours was also noted. Statistical Analysis: Student’s independent t-test was employed for comparing continuous variables. Chi-Square test or Fisher’s exact test was applied for comparing categorical variables. P-value<0.05 was considered significant. Results: Intraoperative analgesic consumption was more in paravertebral group (60%) than pectoral group (32%). Also the VAS scores were more in paravertebral group than pectoral group and were statistically significant (p<0.001) till 4 hours postoperatively and comparable after that till 24 hours. Postoperative morphine consumption was also more in paravertebral group (5.680±0.556 mg versus 4.280±0.678 mg). Efficacy of postoperative analgesia determined by time to first rescue analgesia (170±6.894 min versus 137.24±8.945 min) was more in pectoral block group and hence efficacy was better in pectoral group. Conclusion: Ultrasound guided pectoral block reduced postoperative morphine consumption and pain scores more effectively than thoracic paravertebral block. Intraoperative fentanyl consumption was also less in pectoral block group.
Authors and Affiliations
Farhat Maqbool, Sofi Khalid, Abida Yousuf, Aabid H Mir, Showkat A Nengroo
Keywords
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- EP ID EP521607
- DOI 10.26611/10159321
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