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PECS BLOCK VS THORACIC PARAVERTEBRAL BLOCK FOR THE MANAGEMENT OF POSTOPERATIVE ANALGESIA IN MAJOR BREAST SURGERY: PRELIMINARY FINDINGS
ESRA Academy. SCIMIA P. Sep 8, 2016; 138308; 0136 Topic: Thoracic Paravertebral and Intercostal Blocks
PAOLO SCIMIA
PAOLO SCIMIA

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Abstract
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Background and Aims:

Pecs Block could represent a viable alternative to conventional locoregional techniques for postoperative analgesia in breast surgery. Authors reported preliminary findings of a randomized prospective study comparing analgesic efficacy of Pecs II Block (PB) and Thoracic Paravertebral Block (TPB) for postoperative analgesia in reconstruction breast surgery.

Methods:

Twenty patients were scheduled to undergo radical mastectomy and implant breast reconstruction with expander/prosthesis. We performed PB in group I (10 patients) and TPB in group II (10 patients) under ultrasound guidance. Subsequently, patients of both groups were subjected to general anesthesia. After surgery, pain intensity was detected by NRS scale and also the intravenous morphine consumption was evaluated in the first 48 postoperative hours.

Results:

Pain score evaluation showed statistically significant differences between the two groups. Although, upon awakening, the analgesic efficacy of TPB seemed higher, further evaluations in the first 48 postoperative hours showed improved pain control in favor PB [group I:0,5 +/- 1,41 vs group II:0,6 +/- 1,63]. Similarly, intravenous morphine consumption in the same period was lower in group I [ group I:15,5 mg +/- 8,36  vs  group II:16,33 mg +/- 8,54]. In addition, in group I we obtained a minor procedural pain, reduced time of execution of the technique and a lower rate of complications compared to group II.

Conclusions:

Preliminary findings of our study showed that PB could represent a safe and effective alternative to TPB, especially when standard locoregional techniques are contraindicated or not recommended,improving quality of postoperative analgesia with lower systemic morphine consumption in the first postoperative period.

     

          

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