English

Abstract

Paravertebral nerve block (PVB) is an anesthetic technique that results in less postoperative pain; nausea and vomiting require fewer analgesics. The aim of our study was to compare the postoperative analgesia provided by multilevel thoracic paravertebral injections of bupivacaine (0.5%) and ropivacaine (0.5%) in patients undergoing unilateral breast surgery. MATERIALS AND METHODS: It was a comparative randomized double blind study. Sample size was calculated at 80% study power and α error 0.05 came out to be 25 patients in each group which was further enhanced to 30 patients. Data were analyzed using SPSS version 12. Student's T-test and Chi- square test were applied.60 ASA, I/ II patients, aged 18-56 years, body weight 50-80kg scheduled for unilateral breast surgery were randomly chosen to receive PVB from T2-T5 with either bupivacaine 0.5% (group1) or ropivacaine 0.5% (group 2) 5ml at each level. Variables of efficacy were the amount of fentanyl consumption, postoperative pain on visual analogue pain score (VAS) upto 24 hours. Post-operative nausea and vomiting, any other complication, duration of block and both surgeon and patient's satisfaction score. RESULTS AND OBSERVATION: Time to rescue analgesic was 302.87±75.07 I group 1 and 299.89±86.67 in group 2 and was statistically insignificant( P >0.05)However, mean duration of block was 21.21±5.521 hrs and 22.63±3.874hrs in group 1 and in group 2 which was comparable.(P value >0.05) . Seven patients in group 1 and four patients in group 2 required fentanyl as rescue analgesic. Frequency (times/patient) was 8(0.24±.50) and 6(0.17±.51) in group 1 and 2 respectively. Total dose of fentanyl in mg/kg/patient was 0.12±0.25 and 0.09±0.26 in group 1 and group 2 and is statistically insignificant. (P value >0.05). VAS score in the immediate post operative period was 1.12±0.48 and 1.00±.65 in group 1 and group 2.(P > 0.05)VAS score at 4hr, 8hr, 12hr and at 24 hr remained statistically insignificant. None of the patients in the PVB group had any complication in the first 24-hour in postoperative period. No statistical significances in postoperative nausea (P = 0.274), surgeon and patient's satisfaction score between the groups. CONCLUSION: Both drugs are equally effective in providing postoperative analgesia after breast