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ULTRASOUND-GUIDED BILATERAL THORACIC PARAVERTEBRAL BLOCKS AS AN ADJUNCT TO GENERAL ANAESTHESIA IN PATIENTS UNDERGOING REDUCTION MAMMOPLASTY: A HISTORICAL COHORT STUDY
ESRA Academy. Salviz E. Sep 8, 2016; 138205; 0020 Topic: Peripheral Nerve Blocks
Dr. Emine Aysu Salviz
Dr. Emine Aysu Salviz

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Abstract
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Background and Aims:

We aimed to assess whether the addition of ultrasound-guided thoracic paravertebral blocks (TPVBs) to general anaesthesia (GA) would improve postoperative analgesia in patients undergoing bilateral reduction mammoplasty.

Methods:

After ethics committee approval, data of 70 patients were reviewed. Patients receiving GA were included in Group GA, and patients receiving bilateral TPVBs with 20 mL bupivacaine 0.375% as an adjunct to GA were included in Group TPVBs. All patients were administered intraoperative fentanyl due to hemodynamic parameters, and postoperative tramadol 1 mg/kg in the postoperative care unit (PACU) and/or rescue analgesics on wards if numeric rating scale (NRS) was ≥4. Time to first pain, intraoperative fentanyl requirement, NRS scores, number of patients who required tramadol in the PACU, and rescue analgesic consumption through the postoperative first 2 days were analyzed.

Results:

Sixty-four patients’ data were evaluable. Thirty-four were in Group TPVBs and 30 were in Group GA. Time to first pain was 311[0-1605] min in Group TPVBs and 20[0-120] min in Group GA (P<0.001). Fentanyl requirement was lower in Group TPVBs (P<0.001) (Table 1). NRS scores were lower in the TPVBs group through the postoperative first 2 hours (P<0.001) (Table 2). Only 2/34 patients of the TPVBs group required tramadol in the PACU (P<0.001). On day 1, both metamizole sodium (P<0.001) and paracetamol (P=0.018) consumptions; on day 2, only metamizole sodium consumption were lower in Group TPVBs (P<0.001) (Table 1).

Conclusions:

Adding ultrasound-guided TPVBs to GA postponed time to first pain, reduced opioid and other rescue analgesic consumptions in patients undergoing bilateral reduction mammoplasty.

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