Abstract
Introduction: Pectoral Nerve block is an interfascial plane block which provides analgesia after breast cancer surgery while Thoracic Paravertebral block is also widely used. This study is designed to compare the quality of analgesia after Modified Radical Mastectomy using the two techniques in terms of, the time for the first request of rescue analgesic, 24 hrs analgesic requirement, Visual Analogue Score for pain at rest at 1 and 6 hours postoperatively. Results: Patients undergoing breast cancer surgeries done under general anaesthesia at Govt. Kilpauk Medical College and Govt. Royapettah Hospital, Chennai between January 2017 and June 2017 belonging to ASA 1 & 2 were included in this study, 30 patients in PECS group and 30 in TPB group. In TPB group, the time for first rescue analgesia was between 141-360 minutes postoperatively (n=17, 56.67%) than in PECS group where the time for first rescue analgesia was between 121-240 minutes postoperatively (n=27, 90.00%)(p= postoperatively (n=26, 86.67%) while in PECS group it was 300 mg tramadol postoperatively (n=13, 43.33%)(p= were 0.00 and 2.13 while VAS in PECS group at 1 hour and 6 hours were 2.00 and 4.00(p= unpaired t test) Conclusion: Thoracic paravertebral block reduced the 24 hour analgesic consumption, reduced VAS scores at 1 and 6 hours and prolonged the time required for the first request of analgesic compared to pectoral nerve block after modified radical mastectomy. Keywords: Pectoral nerve block, Thoracic paravertebral block, Modified radical mastectomy.
Highlights
Pectoral Nerve block is an interfascial plane block which provides analgesia after breast cancer surgery while Thoracic Paravertebral block is widely used
This study shows that thoracic paravertebral block is superior to pectoral nerve block, in terms of time for the request of first analgesic, 24 hours analgesic consumption, VAS scores at 1 and 6 hours at rest
Pectoral nerve block is easy to perform, simpler and without any complications but the level of analgesia is lesser than thoracic paravertebral block
Summary
Pectoral Nerve block is an interfascial plane block which provides analgesia after breast cancer surgery while Thoracic Paravertebral block is widely used. This study is designed to compare the quality of analgesia after Modified Radical Mastectomy using the two techniques in terms of, the time for the first request of rescue analgesic, 24 hrs analgesic requirement, Visual Analogue Score for pain at rest at 1 and 6 hours postoperatively. Pectoral nerve block is a newer technique reported by Blanco et al.[1] This study is designed to compare the quality of analgesia after Modified Radical Mastectomy using Pectoral nerve block and Thoracic Paravertebral block, in terms of, the time for the first request of rescue analgesic, 24 hrs analgesic requirement, Visual Analogue Score for pain at rest at 1 and 6 hours postoperatively, Hemodynamic parameters
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