Clinical Evaluation of Ultrasound-Guided Thoracic Paravertebral Block (TPVB) Effect on Postoperative Analgesia in Patients with Breast Cancer after Radical Mastectomy

Objective: To evaluate an ultrasound-guided thoracic paravertebral block (TPVB) on postoperative analgesia in breast cancer patients after radical mastectomy. Methods: Sixty female breast cancer patients underwent radical mastectomy and were randomly divided into the TPVB group and the control group. With 30 cases in each, Patients in the TPVB group received a 20 ml of 0.5% ropivacaine under ultrasound guidance and those in the control group received the same volume normal saline. All patients received patient-controlled intravenous analgesia. Postoperative pain value, were recorded at 1st, 4th, 8th, 12th, 24th and 48th hour at rest and on movement using the Visual Analogue Scale (VAS). The consumption of sufentanil and adverse reactions were also evaluated. The incidence of chronic pain was investigated with telephone interview after 3 month and 6 month, postoperatively. Results: Postoperatively at 1st, 4th, 8th, 12th, 24th hour patients in control group had significantly higher VAS values both at rest and on movement than those in the group treated with a thoracic paravertebral block (P<0.05). The opioid consumption in TPVB group were lower than that in control group (P<0.01).The incidences of nausea, vomit and chronic pain in TPVB group were significantly lower than those in control group. Conclusion: Ultrasound-guided paravertebral block can provide good postoperative analgesia effects for breast cancer patients after radical mastectomy. It reduces the opioid consumption, adverse reactions, and incidence of chronic pain. Decreases postoperative pain values and the need for analgesics during the postoperative 24 h, has obvious advantages in chronic pain relief.