Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia After Breast Cancer Surgery: A Randomized, Controlled, Single-Center Trial

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Nov 21

PMID 26588217

Citations 15

Authors

Lijian Pei

Yidong Zhou

Gang Tan

Feng Mao

Dongsheng Yang

Jinghong Guan

Yan Lin

Xuejing Wang

Yanna Zhang

Xiaohui Zhang

Songjie Shen

Zhonghuang Xu

Qiang Sun

Yuguang Huang

Affiliations

Soon will be listed here.

Abstract

Objectives: The contribution of ultrasound-assisted thoracic paravertebral block to postoperative analgesia remains unclear. We compared the effect of a combination of ultrasound assisted-thoracic paravertebral block and propofol general anesthesia with opioid and sevoflurane general anesthesia on volatile anesthetic, propofol and opioid consumption, and postoperative pain in patients having breast cancer surgery.

Methods: Patients undergoing breast cancer surgery were randomly assigned to ultrasound-assisted paravertebral block with propofol general anesthesia (PPA group, n = 121) or fentanyl with sevoflurane general anesthesia (GA group, n = 126). Volatile anesthetic, propofol and opioid consumption, and postoperative pain intensity were compared between the groups using noninferiority and superiority tests.

Results: Patients in the PPA group required less sevoflurane than those in the GA group (median [interquartile range] of 0 [0, 0] vs. 0.4 [0.3, 0.6] minimum alveolar concentration [MAC]-hours), less intraoperative fentanyl requirements (100 [50, 100] vs. 250 [200, 300]μg,), less intense postoperative pain (median visual analog scale score 2 [1, 3.5] vs. 3 [2, 4.5]), but more propofol (median 529 [424, 672] vs. 100 [100, 130] mg). Noninferiority was detected for all four outcomes; one-tailed superiority tests for each outcome were highly significant at P<0.001 in the expected directions.

Conclusions: The combination of propofol anesthesia with ultrasound-assisted paravertebral block reduces intraoperative volatile anesthetic and opioid requirements, and results in less post operative pain in patients undergoing breast cancer surgery.

Trial Registration: ClinicalTrial.gov NCT00418457.

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Sun C, Li M, Lan L, Pei L, Zhang Y, Tan G Front Oncol. 2023; 13:1096468.

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