CONSUMPTION OF ANALGESIA WITH PARAVERTEBRAL BLOCKS AFTER BREAST CANCER SURGERY
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Keywords
Paravertebral blocks, Breast cancers, Visual analogue score, Analgesia
Abstract
Breast cancer is a life-threatening condition, affecting one in eight women and it is the second leading cause of mortality among females. Most breast surgeries are performed under general anesthesia, with postoperative pain management through opioids.
However, around 40% of patients still experience significant pain after surgery, and up to 50% may develop chronic pain due to improper pain management.
Paravertebral blocks, administered with 0.5% bupivacaine, offer an alternative for managing postoperative pain by targeting nerves associated with the breast. The aim of this study was to evaluate the effectiveness of paravertebral blocks in reducing the need for opioids post-surgery, which could improve patient outcomes by lowering costs and minimizing opioid-related side effects such as nausea and extended hospital stays.
Methodology: The prospective cohort study was conducted in Services hospital Lahore, from October 2018 to December 2019. After approval from ethical review board of institute, total of 93 female patients, aged 18–55 and scheduled for unilateral modified radical mastectomy, were enrolled through convenient sampling technique. Postoperative pain was assessed using the Visual Analogue Scale, with patients administered intravenous tramadol when their VAS score exceeded 3. The primary outcomes measured were VAS scores, duration of analgesia, frequency of analgesic use, and total tramadol consumption over 24 hours.
Results: Of the 93 patients, 60.2% were aged 35–50, and 39.8% were aged 51–65. The average Visual analogue score at the time of the first rescue analgesic was 5.58 ± 0.78, with a mean duration of postoperative analgesia lasting 5.15 ± 1.1 hours (309 ± 66.4 minutes). The frequency of analgesic administration within 24 hours was 3.53 ± 1.1 times, and the mean total tramadol consumption was 88.22 ± 22.3 mg.
Conclusion: Our study revealed that unilateral paravertebral blocks provide prolonged postoperative analgesia. It significantly decreases the need for opioids in patients undergoing breast cancer surgeries. This reduction in analgesic consumption lowers the risk of opioid-related side effects, promoting good recovery, early discharge, and overall improved patient satisfaction.
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Muhammad Kamil Zulfiquar
Post Graduate Trainee, General Surgery Department, Services Hospital, Lahore, Pakistan
Muhammad Saulat Naeem
Post Graduate Trainee, General Surgery Department, Services Hospital, Lahore, Pakistan
Usama Rafi
Post Graduate Trainee, General Surgery Department, Services Hospital, Lahore, Pakistan
Zeeshan Ahmad
Assistant Professor, General Surgery Department, Lahore Medical and Dental College, Lahore, Pakistan.
Ayesha Farooq
Post Graduate Trainee, General Surgery Department, Mayo Hospital, Lahore, Pakistan.
Muhammad Adil Zulfiquar
Post Graduate Trainee, General Surgery Department, Services Hospital, Lahore, Pakistan.
Muhammad Awais
Post Graduate Trainee, General Surgery Department, Services Hospital, Lahore, Pakistan.