Author : Vishal Krishna Pai
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis Comparison Between Single Dose Paravertebral Block and Thoracic Epidural Block for Breast Surgeries: a Prospective Randomized Study by : Vishal Krishna Pai
Download or read book Comparison Between Single Dose Paravertebral Block and Thoracic Epidural Block for Breast Surgeries: a Prospective Randomized Study written by Vishal Krishna Pai and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Goal of Study: Both paravertebral block (PVB) and thoracic epidural block(TEB) are established techniques for postoperativepain relief in thoracic and breast surgeries.Breast surgeries are associated with postoperativepain, nausea and vomiting. With medicaladvances and rise in ambulatory surgeries there is a growing interest towards regional anaesthesiafor breast surgeries. Our study compares two known regional techniques with sedation as the soleanaesthetic plan for benign breast surgeries in terms of intraoperative haemodynamics, postoperativepain, side effects and patient satisfaction.Materials and methods: After ethical committee approval, 80 patients scheduled for unilateralsimple mastectomy were randomized to receive either TEB or PVB. The anaesthetic and analgesicprotocols were similar in both groups. Patients in each group received 15 ml of 0.5% Bupivacaineeither in the thoracic paravertebral region or thoracic epidural region. The primary endpointconsisted to measure the frequency of hypotension episodes defined by a mean arterial pressure(MAP) less than 60 mmHg or a decrease in MAP greater than 20% when compared with thepreoperative value. Secondary endpoints evaluated the amount of intraoperative fluid administration,the use of vasopressor drugs, the analgesic efficacy assessed by the visual analogue scale (VAS),any postoperative events such as PONV, shivering or respiratory complications.Results and discussion: As compared to the PVB group the TEB group showed significantdecrease in both mean blood pressure and heart rate during most of the intraoperative period. Theintraoperative fluid consumption was higher in the TEB group as compared to the PVB group. InGroup TEB 25% (10/40) patients required vasopressors as compared to 10% (4/40) in Group PVB.The total rescue analgesic consumption between the two groups were comparable. PostoperativeVAS between the studied groups was similar. Postoperative events in both the groups werecomparable.Conclusion(s): Single injection PVB and TEB had similar quality of surgical anaesthesia, postoperativepain relief and patient satisfaction however PVB had better hemodynamic stability thanTEB in patients undergoing breast surgeries. Further data and studies will be required to confirm thispreliminary study.