Open AccessComparative Study of the Efficacy and Safety of Ultrasound-guided and Landmark-based Paravertebral Block Technique in Patients undergoing Elective Unilateral Breast Surgery
Author(s) -
Akhil Dhanesh Goel,
Navdeep Sethi,
Kaminder Bir Kaur,
Debashish Paul,
Deepak Dwivedi,
Arijit Ray
Publication year - 2022
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2022/50267.16226
Subject(s) - medicine , surgery , ultrasound , body mass index , ultrasonography , anesthesia , radiology
Identifying the Paravertebral Space (PVS) by its anatomical landmarks is associated with high failure rates and complications. With the advent of Ultrasonography (USG), failure rate has decreased leading to an increased interest in performing USG guided Thoracic Paravertebral Block (TPVB). Aim: To assess the efficacy and safety of ultrasound guided TPVB and its comparison with the landmark-based technique, in patients undergoing elective unilateral breast surgery. Materials and Methods: This cross-sectional study was carried out at Command Hospital, Pune from July 2014 to December 2015, on females between 18-70 years, accepted in American Society of Anaesthesiology (ASA) I-III for unilateral breast surgeries. Patients were divided into two groups with 40 subjects in each group. Group A subjects were treated with anatomical landmark technique and group B subjects with USG guided technique. The p-value 0.05 using Fisher’s-exact test). Mean (SD) time taken for performing the block in group A was 371.10 (10.37) seconds while it was 613.73 (37.15) seconds in group B (p-value <0.05 by two independent sample t-tests). No statistically significant difference was seen in haemodynamic parameters, except for the Heart Rate (HR) at 70, 80, 90 minutes after administering the block and at the end of surgery. Correlation analysis for quantitative variables with PVS depth (dependent variable), measured sonologically, showed very good linear correlation of PVS depth with weight (Pearson correlation coefficient, r=0.819, p-value <0.001). BMI (r=0.884; p-value <0.001). Conclusion: The success rate is higher with ultrasound guided TPVB compared to the landmark technique though statistically insignificant. But it is recommended to use ultrasound-guided TPVB for advantages such as lesser requirement of opioid supplementation, real time visualisation of the spread of drugs in PVS with lesser complication rates.