Single Shot Paravertebral Block - A Novel Approach for Post-Operative Analgesia in Breast Surgeries

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dc.contributor.authorKhushboo Jainen_US
dc.contributor.authorManhas, Ranikaen_US
dc.contributor.authorPankaj, Neelen_US
dc.date.accessioned2020-11-18T10:18:40Z
dc.date.available2020-11-18T10:18:40Z
dc.date.issued2020-09
dc.description.abstractAdvancements in diagnostic sciences have led to increased frequency in detection of cases of breast cancer. After confirmation, majority of these patients undergo definitive surgeries commonly Modified Radical Mastectomy or Lumpectomy under general anaesthesia. In addition to inadequate pain control there is increased incidence of nausea and vomiting during first 24 hrs. of the post-operative period with GA. Parenteral narcotic used routinely in postoperative period further increases nausea and vomiting. The large number of patients hospitalized annually for breast cancer surgeries results in heavy costs and long hospital stays. Regional anaesthesia using prep-incisional paravertebral block (PVB) maybe an ideal alternative to GA alone for breast cancer surgery. Benefits include prolonged postoperative pain relief, reduction in postoperative nausea and vomiting and has potential for early discharge. It results in unilateral sensory, motor and sympathetic blockade with additional advantages of lower side effect profile, early mobilization and fewer contraindications. We wanted to study the efficacy of paravertebral block for postoperative pain relief in breast surgeries. METHODSA prospective, randomized, comparative study involving 60 adult female patients posted for Ca breast surgery was conducted. One group received pre-incisional PVB with GA (group A) and another received GA alone (group B). The efficacy of analgesia and PONV were assessed using Visual Analogue Scale and Numeric Rating Score respectively at T1, 2, 3, 4, 5, 6, 12, 24, 48 hours. Fentanyl 2 mic / Kg as rescue analgesic and ondansetron 0.1 mg / Kg as antiemetic were given at VAS >/= 4 and NRS >/= 2. Total opioid and antiemetic consumption was noted. RESULTSTotal VAS and NRS scores of Group A was significantly lower than Group B. Also significantly reduced consumption of analgesic and antiemetic was observed in Group A. ∑VASA = (3.37 + 2.76) while ∑ VASB = (19.23 + 3.32) while, Group A ∑NRS = (0.47 + 0.67) and Group B ∑NRS = (5.27 + 1.34). CONCLUSIONSPVB provides significant pain relief with decreased incidence of PONV and has the additional advantage of lesser consumption of opioids and antiemetics in the immediate postoperative period.en_US
dc.identifier.affiliationsDepartment of Anaesthesiology, Acharya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu, Jammu and Kashmir, India.en_US
dc.identifier.affiliationsDepartment of Anaesthesiology, Acharya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu, Jammu and Kashmir, India.en_US
dc.identifier.affiliationsDepartment of Anaesthesiology, Bokaro General Hospital, Bokaro Steel City, Jharkhand, India.en_US
dc.identifier.citationKhushboo Jain, Manhas Ranika, Pankaj Neel. Single Shot Paravertebral Block - A Novel Approach for Post-Operative Analgesia in Breast Surgeries. Journal of Evolution of Medical and Dental Sciences. 2020 Sep; 9(38): 2796-2800en_US
dc.identifier.issn2278-4802
dc.identifier.issn2278-4748
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/215200
dc.languageenen_US
dc.publisherAkshantala Enterprises Private Limiteden_US
dc.relation.issuenumber38en_US
dc.relation.volume9en_US
dc.source.urihttps://dx.doi.org//10.14260/jemds/2020/609en_US
dc.subjectPre-incisionalen_US
dc.subjectParavertebral Blocken_US
dc.subjectBreast Surgeryen_US
dc.subjectSingle Shot Approachen_US
dc.subjectPostoperative Analgesiaen_US
dc.titleSingle Shot Paravertebral Block - A Novel Approach for Post-Operative Analgesia in Breast Surgeriesen_US
dc.typeJournal Articleen_US
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