J Med Assoc Thai 2010; 93 (12):149

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General Anesthesia with Thoracic Paravertebral Block for Modified Radical Mastectomy
Arunakul P Mail, Ruksa A

Objective: To evaluate the effect of single-injection paravertebral block (PVB) combined with general anesthesia on 24-hour
postoperative morphine requirement in patients undergoing modified radical mastectomy (MRM).

Material and Method: 20 patients were randomly assigned into 2 groups. Patients in the control group were given only
general anesthesia. Patients in the PVB group received 0.3 ml/kg of 0.5% plain bupivacaine at T4 paravertebral space
followed by general anesthesia. Both groups received intravenous morphine patient-controlled analgesia (PCA) device
postoperatively. All patients were evaluated at 1 and 24 hours for pain, nausea and vomiting. Twenty-four hour morphine
consumption, antiemetics requirement, and overall satisfaction were recorded.

Results: Patients with PVB had lower incidence and severity of postoperative pain, nausea and vomiting and other serious
complications. No patients were unsatisfied with anesthetic techniques.

Conclusion: PVB can reduce postoperative opioid requirement, pain, and severity of nausea and vomiting in MRM.

Keywords :
Modified radical mastectomy, Paravertebral block, General anesthesia

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