| ||||||||||||||
|
|
|||||||||||||

Departments of
*Anesthesiology and
Surgery, Duke University Medical Center, Durham, North Carolina
Address correspondence and reprint requests to Stephen M. Klein, MD, Department of Anesthesiology, Box 3094, Duke University Medical Center, Durham, NC 27710. Address e-mail to klein006{at}mc.duke.edu
Cosmetic and reconstructive breast augmentation is a frequently performed surgical procedure. Despite advances in medical treatment, surgical intervention is often associated with postoperative pain, nausea, and vomiting. Paravertebral nerve block (PVB) has the potential to offer long-lasting pain relief and fewer postoperative side effects when used for breast surgery. We compared thoracic PVB with general anesthesia for cosmetic breast surgery in a single-blinded, prospective, randomized study of 60 women scheduled for unilateral or bilateral breast augmentation or reconstruction. Patients were assigned (n = 30 per group) to receive a standardized general anesthetic (GA) or thoracic PVB (levels T17). Procedural data were collected, as well as verbal and visual analog pain and nausea scores. Verbal postoperative pain scores were significantly lower in the PVB group at 30 min (P = 0.0005), 1 h (P = 0.0001), and 24 h (P = 0.04) when compared with GA. Nausea was less severe in the PVB group at 24 h (P = 0.04), but not at 30 min or 1 h. We conclude that PVB is an alternative technique for cosmetic breast surgery that may offer superior pain relief and decreased nausea to GA alone.
Implications: Paravertebral nerve block has the potential to offer long-lasting pain relief and few postoperative side effects when used for breast surgery. We demonstrated that paravertebral nerve block, when compared with general anesthesia, is an alternative technique for breast surgery that may offer pain relief superior to general anesthesia alone.
This article has been cited by other articles:
![]() |
C. Luyet, U. Eichenberger, R. Greif, A. Vogt, Z. Szucs Farkas, and B. Moriggl Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study Br. J. Anaesth., April 1, 2009; 102(4): 534 - 539. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. McElwain, N. M. Freir, C. L. Burlacu, D. C. Moriarty, D. I. Sessler, and D. J. Buggy The Feasibility of Patient-Controlled Paravertebral Analgesia for Major Breast Cancer Surgery: A Prospective, Randomized, Double-Blind Comparison of Two Regimens Anesth. Analg., August 1, 2008; 107(2): 665 - 668. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Sidiropoulou, O. Buonomo, E. Fabbi, M. B. Silvi, G. Kostopanagiotou, A. F. Sabato, and M. Dauri A Prospective Comparison of Continuous Wound Infiltration with Ropivacaine Versus Single-Injection Paravertebral Block After Modified Radical Mastectomy Anesth. Analg., March 1, 2008; 106(3): 997 - 1001. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. F. Moller, L. Nikolajsen, S. A. Rodt, H. Ronning, and P. S. Carlsson Thoracic Paravertebral Block for Breast Cancer Surgery: A Randomized Double-Blind Study Anesth. Analg., December 1, 2007; 105(6): 1848 - 1851. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. F. White Choice of peripheral nerve block for inguinal herniorrhaphy: is better the enemy of good? Anesth. Analg., April 1, 2006; 102(4): 1073 - 1075. [Full Text] [PDF] |
||||
![]() |
S. M. Klein, H. Evans, K. C. Nielsen, M. S. Tucker, D. S. Warner, and S. M. Steele Peripheral Nerve Block Techniques for Ambulatory Surgery Anesth. Analg., December 1, 2005; 101(6): 1663 - 1676. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. M. Kairaluoma, M. S. Bachmann, A. K. Korpinen, P. H. Rosenberg, and P. J. Pere Single-Injection Paravertebral Block Before General Anesthesia Enhances Analgesia After Breast Cancer Surgery With and Without Associated Lymph Node Biopsy Anesth. Analg., December 1, 2004; 99(6): 1837 - 1843. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. M.-H. Ho, M. K. Karmakar, M. Cheung, and G. C. S. Lam Right thoracic paravertebral analgesia for hepatectomy Br. J. Anaesth., September 1, 2004; 93(3): 458 - 461. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. C. Buckenmaier III, S. M. Klein, K. C. Nielsen, and S. M. Steele Continuous Paravertebral Catheter and Outpatient Infusion for Breast Surgery Anesth. Analg., September 1, 2003; 97(3): 715 - 717. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. A. Terheggen, F. Wille, I. H. Borel Rinkes, T. I. Ionescu, and J. T. Knape Paravertebral Blockade for Minor Breast Surgery Anesth. Analg., February 1, 2002; 94(2): 355 - 359. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. W. Doss, J. Ipe, T. Crimi, S. Rajpal, S. Cohen, R. J. Fogler, R. Michael, and J. Gintautas Continuous Thoracic Epidural Anesthesia with 0.2% Ropivacaine Versus General Anesthesia for Perioperative Management of Modified Radical Mastectomy Anesth. Analg., June 1, 2001; 92(6): 1552 - 1557. [Abstract] [Full Text] [PDF] |
||||
|