title: Comparison of paravertebral and interpleural block in patients undergoing modified radical mastectomy.
abstract: BACKGROUND
  Paravertebral and inter pleural blocks (IPB) reduce post-operative pain and decrease the effect of post-operative pain on lung functions after breast surgery. This study was designed to determine their effect on lung functions and post-operative pain in patients undergoing modified radical mastectomy.
  
  
  METHODS
  A total of 120 American Society of Anesthesiologists physical status 1 and 2 patients scheduled to undergo breast surgery were randomly allocated to receive IPB (Group IPB, n = 60) or paravertebral block (PVB) (Group PVB, n = 60) with 20 ml of 0.5% bupivacaine pre-operatively. A standard protocol was used to provide general anesthesia. Lung function tests, visual analog scale (VAS) for pain at rest and movement, analgesic consumption were recorded everyday post-operatively until discharge.
  
  
  RESULTS
  Lung functions decreased on 1(st) post-operative day and returned to baseline value by 4(th) post-operative day in both groups. VAS was similar in both groups. There was no significant difference in the consumption of opioids and diclofenac in both groups. Complete block was achieved in 48 patients (80%) in paravertebral group and 42 patients (70%) in inter pleural group.
  
  
  CONCLUSIONS
  To conclude, lung functions are well-preserved in patients undergoing modified radical mastectomy under general anesthesia supplemented with paravertebral or IPB. IPB is as effective as PVB for post-operative pain relief. PVB has the added advantage of achieving a more complete block.
authors.affiliation: Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Kundra
authors.forename: Ramesh
authors.initials: R
authors.lastname: Varadharajan
authors.forename: Kotteeswaran
authors.initials: K
authors.lastname: Yuvaraj
authors.forename: Stalin
authors.initials: S
authors.lastname: Vinayagam
keywords: Inter pleural block; lung functions; mastectomy; paravertebral block