Single and double injection paravertebral block comparison in reduction mammaplasty cases: a randomized controlled...

Area of Science:

• Anesthesiology
• Surgical Techniques
• Pain Management

Background:

• Reduction mammaplasty often requires effective postoperative pain management.
• Bilateral thoracic paravertebral block (TPVB) is a regional anesthesia technique used for thoracic and breast surgery.
• Comparing single versus double injection TPVB is crucial for optimizing patient care.

Purpose of the Study:

• To compare the analgesic efficacy and dermatomal blockade of single versus double injection bilateral TPVB.
• To evaluate postoperative pain scores and analgesic consumption.
• To assess the safety and efficiency of different TPVB techniques.

Main Methods:

• 60 patients undergoing bilateral reduction mammaplasty were randomized into single (T3-T4) or double (T2-T3 & T4-T5) injection TPVB groups.
• Bupivacaine 0.375% was administered, and dermatomal blockade was assessed via pin-prick test.
• Pain was managed using paracetamol and tramadol, with Numeric Rating Scale (NRS) scores recorded up to 48 hours postoperatively.

Main Results:

• No significant differences in NRS pain scores were observed between single and double injection TPVB groups at 12 hours postoperatively.
• Secondary outcomes, including dermatomal blockade and overall pain scores, were comparable between the groups.
• The single injection TPVB technique demonstrated a significantly shorter application time.

Conclusions:

• Single injection bilateral TPVB provides adequate dermatomal distribution and pain relief for reduction mammaplasty.
• The single injection technique is advantageous due to its faster and less invasive nature.
• This suggests single injection TPVB as a viable and efficient option for this patient population.