Effects of paravertebral blocks versus liposomal bupivacaine on hospital utilization after mastectomy with reconstruction

Abstract

IntroductionInadequate pain control frequently extends length of stay (LOS) and costs for patients undergoing mastectomy with implant-based reconstruction (IBR). We sought to examine the effects of Paravertebral blocks (PVB) and liposomal bupivacaine (LB) and compare LOS, pain scores and costs of hospitalization. MethodsProspective database review of patients undergoing mastectomy with IBR was performed. Results541 patients were identified. 51/491 (9.4%) received PVB and 50 (9.2%) received LB. LOS in the PVB group was significantly less than that of the no block (NB) group (1 [1–2] days PVB vs 3 [2–4] days NB (p < 0.0001), but was not different from the LB group (1 [1–2] days LB, p = 0.23). PVB patients had lower PACU pain scores compared to NB patients (3.2 ± 2.9 PVB vs 5.7 ± 2.6 NB, p < 0.0001), but similar PACU pain scores to LB patients (4.1 ± 2.3). Patients who received PVB had higher total costs compared to NB patients ($27148±$7053 PVB vs $23113 ± 6860 NB, p = 0.003) but similar to LB patients ($26183 ± $3761). ConclusionPVB and LB are associated with shorter LOS and lower pain scores compared to NB.