EFFICACY OF THORACIC PARAVERTEBRAL BLOCK ANESTHESIA IN BREAST AUGMENTATION SURGERY

Elective cosmetic Breast augmentation is a highly accomplished operation in Kingdom of Saudi Arabia, it can be combined with prominent post-operative pain being a source of concern for patients and their healthcare providers. General anesthesia (GA) has been a standard technique for this surgery. Methodology: A retrospective chart review of 131 patients was conducted at king Abdul Aziz Medical City, Jeddah in the period of 2002-2012. Our study sample was 60 patients divided into two groups, one who underwent GA alone, and the other one underwent GA with bilateral single injection at single level T3-T4 TPVB of 0.2-0.5% bupivacaine + epinephrine 5 mcg/ml (1:200000) before the induction of GA. The primary outcome assessed was the amount of post-operative analgesic use in both groups in the 1st 24 hours. Results: Overall, the patients' traits and anesthetic technique were proportionate between the two groups. Bilateral single injection TPVB significantly decrease the need for analgesics (=10.549, 1df, P= 0.001), and antiemetic needs (=16.98,1df,P=0). There was a statistically difference in the duration of hospital stay between the 2 groups (=4.23, 1df, P=0.04). The pain visual analogue score in the group with the TPVB was significantly decreased (=4.23, 1df, P=0.01). Conclusion: we found a statistically significant difference between both groups, which present efficacy of using TPVB. We advocate the use of TPVB in all breast augmentations.