Effect of thoracic paravertebral block combined with general anesthesia on long-term quality of life in patients undergoing breast cancer surgery

Abstract

Objective To evaluate the effect of thoracic paravertebral block (TPVB) combined with general anesthesia on the long-term quality of life in the patients undergoing breast cancer surgery. Methods A total of 156 patients, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing breast cancer surgery, were randomly assigned to TPVB combined with general anesthesia group (TPVB+ GA group, n=78) and general anesthesia group (GA group, n = 78), and the patients in two groups were matched with a ratio of 1∶1.In group TPVB+ GA, propofol (target effect-site concentration 2.5-4.0 μg/ml) was given by target-controlled infusion, and patients received either single or multiple injections (T1-T5) of TPVB under ultrasound guidance at 30 min before induction of general anesthesia.Group GA inhaled 2.0%-2.5% sevoflurane.The patients were followed up at 6 and 12 months after operation, postoperative chronic pain and chronic pain affecting daily life were assessed using the modified Brief Pain Inventory, the development of neuropathic pain using neuropathic pain questionnaire-short form, and the development of long-term health-related quality of life by using the 12-item short-form scale. Results There was no significant difference in the incidence of chronic pain and chronic pain affecting daily life, incidence of neuropathic pain or quality of life scale score at 6 and 12 months postoperatively between the two groups (P>0.05). Conclusion TPVB combined with general anesthesia exerts no effect on the long-term quality of life in the patients undergoing breast cancer surgery. Key words: Thoracic vertebrae; Nerve block; Anesthesia, general; Breast neoplasms; Quality of life