Comparative study between thoracic epidural and ultrasound-guided thoracic paravertebral block in perioperative pain management for mastectomy

Abstract

Objectives To compare between ultrasound-guided thoracic paravertebral block (PVB) and thoracic epidural block in patients undergoing mastectomy for pain control, intraoperative hemodynamics, and postoperative patient satisfaction. Background Thoracic PVB and thoracic epidural appears promising when combined with general anesthesia in reduction of postoperative pain. Patients and methods Between mid-2016 and December 2017, this prospective clinical study included 60 female patients scheduled for a unilateral mastectomy in Menoufia University Hospitals and divided into two groups, 30 each. Patients in group A were given single shot ultrasound-guided PVB at T4 level using 0.3 ml/kg of 0.5% bupivacaine. Patients in group B were given single shot epidural block at T4 level using 2 ml/segment of 0.5% bupivacaine. Results A total of 60 patients were included, of them, 30 patients received PVB and 30 received thoracic epidural. Heart rate was significantly higher in paravertebral group than in thoracic epidural group (P Conclusion Ultrasound-guided PVB is an effective technique showing greater hemodynamics stability and pain control compared with epidural analgesia for mastectomy.