General Anesthesia with Thoracic Paravertebral Block for Modified Radical Mastectomy
Preeyaphan Arunakul MD* Acksara Ruksa RN**
Affiliation : *Department of Anesthesia, Faculty of Medicine, Thammasat University, Pathumthani, Thailand **Thammasat University Hospital, Pathumthani, Thailand
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
