Thoracic paravertebral regional anesthesia for pain relief in patients with breast cancer surgery

Medicine (Baltimore). 2017 Sep;96(39):e8107. doi: 10.1097/MD.0000000000008107.

Abstract

Background: The present study aimed to assess the efficacy and safety of thoracic paravertebral regional anesthesia (TPVBRA) in patients with breast cancer surgery.

Methods: In total, 72 patients undergoing breast cancer surgery were randomly divided into an intervention group and a control group; each group contained 36 subjects. Both groups received TPVBRA with 20 mL 0.25% bupivacaine. In addition, subjects in the intervention group also received an additional 1 μg/kg dexmedetomidine. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), pain intensity (measured by visual analogue scale, VAS), and analgesic consumption were assessed; adverse events were also recorded.

Results: Significant differences were observed in HR (P < .05), SBP (P < .05), and DBP (P < .05) at the 30-minute point during surgery between the 2 groups. In addition, the time of the first administration of analgesia (P = .043) and the mean consumption of analgesic agents (P = .035) in the intervention group were much better than those in the control group. However, no significant differences in HR or VAS were found at any time point after surgery (P > .05). Furthermore, similar adverse events were detected in both groups (P > .05).

Conclusion: The results of this study showed that TPVBRA combined with bupivacaine and dexmedetomidine can enhance the duration and quality of analgesia without serious adverse events.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analgesics, Non-Narcotic / administration & dosage*
  • Anesthesia, Epidural / methods*
  • Anesthetics, Local / administration & dosage*
  • Breast Neoplasms / surgery*
  • Bupivacaine / administration & dosage
  • Dexmedetomidine / administration & dosage
  • Female
  • Humans
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control*
  • Thoracic Vertebrae
  • Treatment Outcome

Substances

  • Analgesics, Non-Narcotic
  • Anesthetics, Local
  • Dexmedetomidine
  • Bupivacaine