RESUMO
OBJECTIVE: The aim: to compare the efficacy of pectoral nerve block type II and thoracic paravertebral block for analgesia during and after breast cancer surgery. PATIENTS AND METHODS: Materials and methods: Sixty adult women were undergoing unilateral radical mastectomy or quadrantectomy with axillary dissection. Patients were randomized to receive either pectoral nerve block with ropivacaine 0.375% 30 ml or thoracic paravertebral block with ropivacaine 0.5% 20 ml. Evaluated variables included pain intensity at 0, 2, 4, 6, 12, 18 and 24 hours, intraoperative fentanyl, 24-hour postoperative opioid (promedol) and nonopioid (ketoprofen) consumption, the time to first rescue analgesia. RESULTS: Results: There were no statistically significant differences between pectoral block and paravertebral block groups in intraoperative fentanyl consumption 2,2 (1,81-2,81) vs 1,9 (1,63-2,25) mcg/kg/hour (Ð >0,05) and in the pain intensity during the first 24 hours after operation. The mean postoperative 24-hour promedol and ketoprofen consumption was 4,0 (±8,14) mgvs 5,0 (±8,85) mg (Ð >0,05) and 66,7 (±66,09) mgvs 95,8 (±90,78) mg (Ð >0,05) in the pectoral and paravertebral block groups respectively. Time to the first analgesia request was longer in pectoral block group - 540 (455,0-600,0) min vs 515 (265,0-650,0) min (Ð >0,05). There were no complications after pectoral blocks and 2 complications after paravertebral blocks. CONCLUSION: Conclusions: in breast cancer surgery pectoral nerve blocktype II can provide postoperative analgesia comparable to thoracic paravertebral block with lower complications rate.
