Mishra Navya, Haque Ekramul, Bhagat Manisha, Kumar Vishwanath, Suwalka Usha, Gorai Piu
Anaesthesiology, Rajendra Institute of Medical Sciences, Ranchi, IND.
Cureus. 2021 Sep 27;13(9):e18322. doi: 10.7759/cureus.18322. eCollection 2021 Sep.
General anaesthesia (GA) is the conventional technique used for surgical treatment of breast lumps. However, various side effects and complications of GA, such as postoperative pain, nausea, vomiting, and increased hospital stay increase morbidity in patients. Regional anaesthesia using multiple injection paravertebral block is an ideal alternative to GA for breast surgeries.
Sixty female patients posted for unilateral breast surgery were randomly divided into two groups, Group P for paravertebral block and group G for GA, and compared on the basis of time taken for induction of anaesthesia, postoperative pain relief on basis of Visual Analogue Scale (VAS) score, postoperative nausea and vomiting (PONV) and duration of hospital stay.
Duration of surgery in group P was 64.75±18.07 and 67.32±17.64 in group G respectively (P>0.05). Time for inducing anaesthesia was significantly longer in group P (17.15±3.92min) compared to group G (5.90±1.75min) with P<0.05. Significant difference (P<0.001) was observed in the mean duration of postoperative analgesia of group P (298.34±67.02min) and group G (107.68±27.28min). The VAS scores in immediate postoperative period and after two and four hours in the postoperative period were significantly higher in group G (P<0.05). The incidence of postoperative nausea and vomiting was significantly higher in group G (13 out of 30 patients) than group P (four out of 28 patients) with P<0.05.
The efficacy and safety of paravertebral block for operative treatment of breast tumors, excellent analgesia in early postoperative period, requirement of significantly lesser amount of postoperative analgesics, decreased incidence of PONV and negligible complications along with early ambulation and hospital discharge makes it an afferent cost-effective block of choice for unilateral breast surgeries.
全身麻醉（GA）是用于乳腺肿块手术治疗的传统技术。然而，全身麻醉的各种副作用和并发症，如术后疼痛、恶心、呕吐以及住院时间延长，会增加患者的发病率。使用多次注射椎旁阻滞的区域麻醉是乳腺手术中全身麻醉的理想替代方法。
将60例拟行单侧乳腺手术的女性患者随机分为两组，P组为椎旁阻滞组，G组为全身麻醉组，并根据麻醉诱导时间、基于视觉模拟量表（VAS）评分的术后疼痛缓解情况、术后恶心呕吐（PONV）及住院时间进行比较。
P组手术时间分别为64.75±18.07，G组为67.32±17.64（P>0.05）。P组诱导麻醉时间（17.15±3.92分钟）明显长于G组（5.90±1.75分钟），P<0.05。P组（298.34±67.02分钟）和G组（107.68±27.28分钟）术后镇痛的平均持续时间存在显著差异（P<0.001）。术后即刻及术后两小时和四小时时，G组的VAS评分明显更高（P<0.05）。G组术后恶心呕吐的发生率（30例患者中有13例）明显高于P组（28例患者中有4例），P<0.05。
椎旁阻滞用于乳腺肿瘤手术治疗的有效性和安全性、术后早期的良好镇痛效果、术后镇痛药物用量显著减少、PONV发生率降低以及并发症可忽略不计，同时早期活动和出院，使其成为单侧乳腺手术一种经济有效的理想阻滞方法。
