Use of Paravertebral Block as an Alternative to General Anesthesia for Breast Surgeries: A Randomized Control Study

Navya Mishra; Ekramul Haque; Manisha Bhagat; Vishwanath Kumar; Usha Suwalka; Piu Gorai

doi:10.7759/cureus.18322

Use of Paravertebral Block as an Alternative to General Anesthesia for Breast Surgeries: A Randomized Control Study

Cureus. 2021 Sep 27;13(9):e18322. doi: 10.7759/cureus.18322. eCollection 2021 Sep.

Authors

Navya Mishra¹, Ekramul Haque¹, Manisha Bhagat¹, Vishwanath Kumar¹, Usha Suwalka¹, Piu Gorai¹

Affiliation

¹ Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, IND.

Abstract

Background: General anaesthesia (GA) is the conventional technique used for surgical treatment of breast lumps. However, various side effects and complications of GA, such as postoperative pain, nausea, vomiting, and increased hospital stay increase morbidity in patients. Regional anaesthesia using multiple injection paravertebral block is an ideal alternative to GA for breast surgeries.

Methods: Sixty female patients posted for unilateral breast surgery were randomly divided into two groups, Group P for paravertebral block and group G for GA, and compared on the basis of time taken for induction of anaesthesia, postoperative pain relief on basis of Visual Analogue Scale (VAS) score, postoperative nausea and vomiting (PONV) and duration of hospital stay.

Results: Duration of surgery in group P was 64.75±18.07 and 67.32±17.64 in group G respectively (P>0.05). Time for inducing anaesthesia was significantly longer in group P (17.15±3.92min) compared to group G (5.90±1.75min) with P<0.05. Significant difference (P<0.001) was observed in the mean duration of postoperative analgesia of group P (298.34±67.02min) and group G (107.68±27.28min). The VAS scores in immediate postoperative period and after two and four hours in the postoperative period were significantly higher in group G (P<0.05). The incidence of postoperative nausea and vomiting was significantly higher in group G (13 out of 30 patients) than group P (four out of 28 patients) with P<0.05.

Conclusion: The efficacy and safety of paravertebral block for operative treatment of breast tumors, excellent analgesia in early postoperative period, requirement of significantly lesser amount of postoperative analgesics, decreased incidence of PONV and negligible complications along with early ambulation and hospital discharge makes it an afferent cost-effective block of choice for unilateral breast surgeries.

Keywords: analgesia cancer-related breast surgery; pain on vas; paravertebral block (pvb); post operative pain; unilateral breast surgery.