Analgesia in patients with or without single-shot lamina thoracic paravertebral block following breast cancer surgery in a Nigerian hospital

Abstract

Background: In this pilot study, we evaluated the postoperative analgesic effect of the new lamina thoracic paravertebral block using a single-shot technique for major breast cancer surgery.

Methods: A retrospective observational design was used to compare data involving 16 consecutive ASA 1 and 2 female patients who had unilateral modified radical mastectomy with axillary clearance under general anaesthesia with paravertebral block and 15 others without block between 13/03/2014 to 12/05/2015. We compared the time to the first request for analgesic, total analgesic (opioid and non-opioid) consumption (in mg) and postoperative pain scores over 72 h between the two groups.

Results: One patient was excluded from the cohort due to block failure. The median time to first request for analgesic was 43 h (25.2-73.0 h) in the block group versus 2 h (1.0-2.5 h), p=0001. The pain scores was significantly lower at all measurement points among the block patients compared with the no-block group until 24 h postoperatively. No patient in the block group required analgesic within 24 h after surgery. The total consumption of pentazocine was nil (block group) vs. 154.0±74.2 (range 90-300) mg, p=0.0000001.

Conclusions: Single-shot lamina paravertebral block provided prolonged postoperative analgesia and reduced opioid and non-opioid consumption.