Abstract
Background: General anaesthesia (GA) is the conventional technique used for surgical treatment of breast lumps. However, various side effects and complications of GA, such as postoperative pain, nausea, vomiting, and increased hospital stay increase morbidity in patients. Regional anaesthesia using multiple injection paravertebral block is an ideal alternative to GA for breast surgeries.Methods: Sixty female patients posted for unilateral breast surgery were randomly divided into two groups, Group P for paravertebral block and group G for GA, and compared on the basis of time taken for induction of anaesthesia, postoperative pain relief on basis of Visual Analogue Scale (VAS) score, postoperative nausea and vomiting (PONV) and duration of hospital stay.Results: Duration of surgery in group P was 64.75±18.07 and 67.32±17.64 in group G respectively (P>0.05). Time for inducing anaesthesia was significantly longer in group P (17.15±3.92min) compared to group G (5.90±1.75min) with P<0.05. Significant difference (P<0.001) was observed in the mean duration of postoperative analgesia of group P (298.34±67.02min) and group G (107.68±27.28min). The VAS scores in immediate postoperative period and after two and four hours in the postoperative period were significantly higher in group G (P<0.05). The incidence of postoperative nausea and vomiting was significantly higher in group G (13 out of 30 patients) than group P (four out of 28 patients) with P<0.05.Conclusion: The efficacy and safety of paravertebral block for operative treatment of breast tumors, excellent analgesia in early postoperative period, requirement of significantly lesser amount of postoperative analgesics, decreased incidence of PONV and negligible complications along with early ambulation and hospital discharge makes it an afferent cost-effective block of choice for unilateral breast surgeries.
Highlights
Breast surgeries are very common in India, which has a high incidence rate of breast cancer (25.8 per 1,00,000 women) and fibroadenoma breast (45.5%) [1,2]
After the approval obtained by the Institutional Review Board of Rajendra Institute of Medical Sciences (RIMS) ethical committee (104,10/4), written consent was obtained from 60 female patients aged 18-65 years, ASA physical status I and II scheduled for unilateral breast surgery without axillary extension who were included in our randomized clinical study
In two patients of group P we had to administer General anaesthesia (GA) due to inadequate effect of block and they were excluded from the study whereas in group G all patients were successfully administered GA
Summary
Breast surgeries are very common in India, which has a high incidence rate of breast cancer (25.8 per 1,00,000 women) and fibroadenoma breast (45.5%) [1,2]. General anesthesia (GA) has always been the conventional technique used for surgery of breast lumps. Various side effects and complications of GA were noted such as postoperative pain, nausea, and vomiting in patients. Regional anaesthesia using multiple injection paravertebral block (PVB) is an ideal alternative to GA for breast surgeries. The aim of our study was to compare the efficacy of thoracic PVB as an anesthetic procedure for elective breast lump surgeries with GA, duration of postoperative pain relief being the primary objective. General anaesthesia (GA) is the conventional technique used for surgical treatment of breast lumps. Various side effects and complications of GA, such as postoperative pain, nausea, vomiting, and increased hospital stay increase morbidity in patients. Regional anaesthesia using multiple injection paravertebral block is an ideal alternative to GA for breast surgeries
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