Single-site versus multiple-sites percutaneous thoracic paravertebral block in breast surgery

ABSTRACT

Alternative forms of anaesthesia in breast surgery have been sought to reduce the untoward effects of general anaesthesia. Unilateral paravertebral nerve blockade has been reported to produce excellent afferent nerve block that overcomes all the disadvantages of general anaesthesia. The aim of the present study was to compare single-site and multiple-sites techniques of thoracic paravertebral block in breast surgery. After written informed consent, sixty women [ASA I, II] were enrolled in this prospective study, randomly allocated to receive either a single-site paravertebral block at the level of T4 [30 women] or multiple-sites paravertebral block at the levels from T1 to T6 [30 women]. The end points of the study were failure rate, complications, haemodynamic parameters, and the post operative analgesic profiles [visual analogue score and opioid requirements]. Failure rate was 6.67% in both groups and without any complications after the block. There was obvious haemodynamic stability in all the way through intra and postoperative periods in all patients with no significant difference between the two studied groups. The two techniques used in this study resulted in low visual analogue scores and low opioid supplementations in the postoperative period with no significant difference between the two groups. Single-site paravertebral block is as multiple-sites paravertebral block as regards efficacy, haemodynamic stability, and post operative analgesic effect in unilateral breast surgery without axillary dissection