Thoracic Paravertebral Block in Oncologic Breast Surgery

Abstract

Introduction: Paravertebral block is a technique that provides unilateral multisegmental anesthesia/analgesia in thoracic and abdominal surgery.

Objective: To evaluate the effectiveness and safety of thoracic paravertebral block in patients undergoing breast oncologic surgery.

Methods: A quasiexperimental, prospective and longitudinal study was conducted at Hospital Universitario General Calixto García, between January and December 2022. The sample was divided into two groups of 50 patients each. The study group received thoracic paravertebral block and the control group received thoracic epidural analgesia.

Results: Mean arterial blood pressure and heart rate were significantly lower in the control group. There were no differences in postoperative pain intensity between the two groups. 10 % of the study group and 12 % of the control group requested rescue analgesia, with an average time up to the first rescue analgesia of 8.1 ± 2.5 hours in the study group and 7.6 ± 2.9 hours in the control group. Complications occurred in 2 % of the study group and in 6 % of the control group. 90 % of the study group and 88 % of the control group were satisfied with the procedure.

Conclusions: Thoracic paravertebral block was as effective and safe as thoracic epidural analgesia, in patients undergoing breast oncologic surgery. These patients presented similar characteristics of sensory block such as greater hemodynamic stability, similar postoperative pain intensity, need and time to request rescue analgesia, degree of patient satisfaction, and a lower frequency of complications.

Keywords: breast cancer; epidural analgesia; epidural injections: paravertebral block.