Appropriate Analgesia for Breast Surgery By Paravertebral Anesthesia

Introduction: Due to the increasing number of breast masses and a more precise attention to them, a greater number of patients refer to clinics for biopsy or resection of breast and axillary lymph nodes. An appropriate anesthesia method can decrease hospitalization time, its expenditure and postoperative complications. Paravertebral anesthesia [1] is a simple and feasible method in most cases and can provide a very suitable analgesia for biopsy and operation and postoperative analgesia.

Method: Paravertebral block was used for analgesia for 15 women having breast masses who were candidates for biopsy and pathology examination by frozen section. Biopsy was performed only by a single paravertebral injection (we did not insert catheter for continuos analgesia) with sedation. The patients' satisfaction and analgesia were evaluated postoperatively. First pain complaint and burning which demanded opioid prescription was considered at the end of analgesia of the block. The patients were evaluated for analgesia for 24 hours.

Results: Paravertebral block provides an appropriate analgesia for breast surgery, and with good technical performance it offers a high rate of success. Average duration of analgesia was 17 hours and the patients did not need opioid in this period; 60% of the patients (9 people) were discharged at the same day of the surgery in the afternoon. Those patients requiring mastectomy following the biopsy were anesthetized with tracheal intubation and atracurium muscle relaxant, and no opioid drug was used in their surgery. All the patients (15people) expressed their satisfaction with paravertebral block.

Conclusion: Breast surgeries with paravertebral block were performed with a high rate of analgesia and patients' consent, a good reduction in patients’ expenditure and much lower incidence of complications and early ambulation of patients. Other regional methods like thoracic epidural block, intercostals block and local infiltrations are also used for these surgeries. However, as the duration of surgeries differs from one another, a safe and comprehensive method is important, and paravertebral block has these characteristics.