Abstract:

Breast conserving surgery (BCS) is frequently performed in early stage breast cancers. Thoracic paravertebral block (TPVB) is an accepted method in the pain management of breast surgery. In recent years, newly defined ESPB has come to the fore as a safe, easy method with similar analgesic effects. Our study is to compare opioid consumption and analgesia effectiveness of TPVB and ESPB in BCS. The observational prospective study was completed with a total of 85 patients, 43 in Group P(TPVB) and 42 in Group E(ESPB). Blocks were applied at the T4 level with 20 ml of 0.375% bupivacaine under ultrasonography preoperatively. The primary outcome was morphine consumption at postoperative 24 hours, secondary outcomes were postoperative pain scores at 0 and 30 minutes, 1, 4, 6, 12 and 24 hours, need for rescue analgesia, block application times, and nausea-vomiting side effects.Morphine consumption was lower in Group P (17.582.29 mg) than in Group E (18.962.67 mg). (p=0.012) Pain scores at rest and at movement were similar at all times. Rescue analgesia was performed in two patients in Group P and in five patients in Group E. (p>0.05) Block application time was longer in Group P (78.6210.93 seconds) than Group E (57.177.84 seconds). (p<0.001) Nausea was observed in five (11.6%) patients in Group P and in seven (16.7%) patients in Group E. (p>0.05) TPVB and ESPB provided similar analgesic efficacy in BCS. However, ESPB is a good alternative as it is easier to implement.

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