title: Ultrasound-Guided Bilateral Thoracic Paravertebral Blocks as an Adjunct to General Anesthesia in Patients Undergoing Reduction Mammaplasty: A Historical Cohort Study.
abstract: BACKGROUND
  This study investigates whether ultrasound-guided thoracic paravertebral blocks would improve postoperative analgesia in patients undergoing bilateral reduction mammaplasty.
  
  
  METHODS
  After obtaining ethics committee approval, data of 70 patients who underwent bilateral reduction mammaplasty were reviewed. Sixty-four patients' data were evaluable; 30 were in the general anesthesia group and 34 were in the thoracic paravertebral block group. Data such as time to first pain, intraoperative fentanyl requirement, postoperative numeric rating scale scores, number of patients who required tramadol in the postoperative care unit, and rescue analgesic consumption through the first 2 postoperative days were analyzed.
  
  
  RESULTS
  Time to first pain was 311 minutes (range, 0 to 1605 minutes) and 20 minutes (range, 0 to 120 minutes) in the thoracic paravertebral block and general anesthesia groups, respectively (p < 0.001). Fentanyl requirement was 52.94 ± 11.94 µg and 115 ± 29.79 µg in the thoracic paravertebral block and general anesthesia groups, respectively (p < 0.001). Numeric rating scale scores were lower in the thoracic paravertebral block group through the first 2 postoperative hours (p < 0.001), and only two of 34 patients required tramadol in the postoperative care unit (p < 0.001). On postoperative day 1, both metamizole sodium (p < 0.001) and paracetamol (p = 0.018), and on day 2, only metamizole sodium (p < 0.001) consumption was lower in the thoracic paravertebral block group.
  
  
  CONCLUSIONS
  Adding ultrasound-guided thoracic paravertebral blocks to general anesthesia postponed time to first pain and reduced analgesic consumption in patients undergoing bilateral reduction mammaplasty.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Emine A
authors.initials: EA
authors.lastname: Salviz
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Nukhet
authors.initials: N
authors.lastname: Sivrikoz
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Anil
authors.initials: A
authors.lastname: Ozonur
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Mukadder
authors.initials: M
authors.lastname: Orhan-Sungur
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Meltem
authors.initials: M
authors.lastname: Savran-Karadeniz
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Demet
authors.initials: D
authors.lastname: Altun
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Emre
authors.initials: E
authors.lastname: Hocaoglu
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Burcu
authors.initials: B
authors.lastname: Celet-Ozden
authors.affiliation: Istanbul, Turkey.|From the Departments of Anesthesiology and Plastic and Reconstructive Surgery, Istanbul University, Istanbul Faculty of Medicine.
authors.forename: Kamil M
authors.initials: KM
authors.lastname: Tugrul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000768:Anesthesia, General; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D016037:Single-Blind Method; D013900:Thoracic Nerves; D014147:Tramadol / Q000627:therapeutic use; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol