Ultrasound-Guided Thoracic Paravertebral Blocks in Patients Undergoing Reduction Mammoplasty
Status:
Completed
Trial end date:
2016-01-01
Target enrollment:
Participant gender:
Summary
Background: Thoracic paravertebral blocks (TPVBs) have been effective for postoperative
analgesia in mastectomy, thoracic and video-assisted thoracic surgeries.
Objective: To assess whether addition of ultrasound-guided TPVBs to general anaesthesia (GA)
could postpone time to first pain and improve postoperative analgesia in patients undergoing
bilateral reduction mammoplasty.
Design: A historical cohort study. Patients: Of the 70 female patients who underwent
bilateral reduction mammoplasty, 64 patients had complete data in the acute pain/regional
anaesthesia database.
Intervention: Thirty patients, received only GA, were included in Group GA. Thirty-four
patients, received bilateral single injection ultrasound-guided TPVBs with 20 mL bupivacaine
0.375% as an adjunct to GA, were included in Group TPVBs. Patients in both groups were
administered intraoperative fentanyl if heart rate or mean arterial pressure increased >20%
above pre-induction values, postoperative tramadol 1mg/kg in the postoperative care unit
(PACU) if numeric rating scale (NRS) was ≥4, and rescue analgesics as metamizole sodium 4x1g
and/or paracetamol 3x1g on wards (NRS≥4).
Main outcome measures: The primary endpoint was time to first pain after the surgery.
Secondary endpoints were intra- and postoperative opioid and other rescue analgesic
requirements, length of stay in the PACU, pain scores, incidence of postoperative nausea and
vomiting (PONV), and patient and surgeon satisfaction through the postoperative first 2 days.