Improved postoperative pain control using thoracic paravertebral block for breast operations

Judy C. Boughey, Farzin Goravanchi, Ronald N. Parris, Spencer S. Kee, John C. Frenzel, Kelly K. Hunt, Frederick C. Ames, Henry M. Kuerer, Anthony Lucci

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Thoracic paravertebral block (PVB) in breast surgery can provide regional anesthesia during and after surgery with the potential advantage of decreasing postoperative pain. We report our institutional experience with PVB over the initial 8 months of use. All patients undergoing breast operations at the ambulatory care building from September 09, 2005 to June 28, 2005 were reviewed. Comparison was performed between patients receiving PVB and those who did not. Pain scores were assessed immediately, 4 hours, 8 hours and the morning after surgery. 178 patients received PVB and 135 patients did not. Patients were subdivided into three groups: Group A-segmental mastectomy only (n = 89), Group Bsegmental mastectomy and sentinel node surgery (n = 111) and Group C-more extensive breast surgery (n = 113). Immediately after surgery there was a statistically significant difference in the number of patients reporting pain between PVB patients and those without PVB. At all time points up until the morning after surgery PVB patients were significantly less likely to report pain than controls. Patients in Group C who received PVB were significantly less likely to require overnight stay. The average immediate pain scores were significantly lower in PVB patients than controls in both Group B and Group C and approached significance in Group A. PVB in breast surgical patients provided improved postoperative pain control. Pain relief was improved immediately postoperatively and this effect continued to the next day after surgery. PVB significantly decreased the proportion of patients that required overnight hospitalization after major breast operations and therefore may decrease cost associated with breast surgery.

Original languageEnglish (US)
Pages (from-to)483-488
Number of pages6
JournalBreast Journal
Volume15
Issue number5
DOIs
StatePublished - Sep 1 2009

Keywords

  • Breast surgery
  • Length of stay
  • Pain control
  • Paravertebral block
  • Postoperative pain
  • Regional anesthesia

ASJC Scopus subject areas

  • Internal Medicine
  • Surgery
  • Oncology

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    Boughey, J. C., Goravanchi, F., Parris, R. N., Kee, S. S., Frenzel, J. C., Hunt, K. K., Ames, F. C., Kuerer, H. M., & Lucci, A. (2009). Improved postoperative pain control using thoracic paravertebral block for breast operations. Breast Journal, 15(5), 483-488. https://doi.org/10.1111/j.1524-4741.2009.00763.x