Journal of AdvancedMedical and Dental Sciences Research

Background: Thoracic paravertebral block (PVB) and thoracic epidural appears promising due to reduction in post-operative pain, decreased opioid consumption with reduction in PONV, drowsiness, risk of respiratory depression and cost saving. The present study was conducted to compare thoracic epidural block vs paravertebral block in patients of breast surgery. Materials & Methods: 72 females selected for unilateral breast surgery were classified into 2 groups of 36 each. Group I patients received thoracic epidural single shot at T4 level using 2ml/segment of 0.5% ropivacaine and group II patients received thoracic single shot paravertebral block at T2 level using 0.3 ml/kg of 0.5% ropivacaine. Parameters such as mean blood pressure, respiratory rate, Ramsey sedation score, performance time, induction time, duration of surgery, total propofol required, total fentanyl required etc. was recorded. Results: Duration of surgery (min) was 70.2 and 69.0, performance time (min) was 7.04 and 6.12, systolic blood pressure (mm Hg) was 114.6 and 126.4, respiratory rate (breadth/min) was 20.1 and 19.3, Ramsey sedation score was 1.61 and 1.89, induction time (min) was 16.7 and 17.4, total propofol required (mg) was 124.2 and 143.5, total fentanyl required (µg) was 121.5 and 123.8, total fluid (RL) required (l) was 1.98 and 1.41, time to rescue analgesic (min) was 306.4 and 304.2 and patient satisfaction score was 87.5 and 85.2 in group I and II respectively (P< 0.05). Nausea/ vomiting was seen in 7 in group I and 1 in group II. Hypotension requiring vasopressors was seen in 8 in group I and 2 in group II. The difference was significant (P< 0.05). Conclusion: Both epidural and paravertebral provide optimal surgical condition and analgesia along with good patient satisfaction.