Thoracic paravertebral block for analgesia after modified radical mastectomy

Abstract

Background: Surgical intervention is associated with postoperative pain, nausea and vomiting. Paravertebral blockade (PVB) has been advocated as a useful technique for analgesia after breast surgery. Aims and Objectives: The aim is to study the efficacy of PVB and associated complications against intramuscular diclofenac sodium 0.75mg. Materials and Methods: Fifty patients of ASA grade I and II were randomized to receive either PVB (group A) or intramuscular diclofenac sodium (group B); there were 25 patients in each group. Group A patients received PVB with catheter at T3 and T6 levels with 0.3ml/kg 0.25% bupivacaine, whereas group B patients received intramuscular diclofenac sodium preoperatively. All patients were observed for quality and duration of analgesia, incidence of nausea and vomiting, hemodynamic stability, and complication. Results: The patients given PVB experienced lower visual analog score (VAS) at rest (P < 0.001) and longer duration of analgesia (P < 0.001) on movement (P < 0.0001) for 1 to 12 h in postoperative period as compared to group B. In group A, fewer patients required rescue analgesia and experienced less postoperative nausea and vomiting as compared to group B. Conclusion: PVB provides better pain control and decreased nausea and vomiting after modified radical mastectomy.

Keywords

• Catheter technique
• mastectomy
• paravertebral block
• postoperative pain