Comparing the Efficacy of Thoracic Paravertebral Block and Diclofenac to Reduce Postoperative Pain in Patients undergoing Unilateral Mastectomy: A Prospective Randomized Controlled Trial

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Apinya Kittiponghansa
Chakthip Suttinarakorn
Wiwanrach Yingphoonphon
Pathawat Plengpanich
Wilawan Somdee
Amornsiri Kotesombut

Abstract

Background: Breast surgery is associated with postoperative pain, nausea, and chronic pain. Thoracic paravertebral block (TPVB) and diclofenac are analgesic adjuvant to manage postoperative pain. Objectives: To compare the efficacy of TPVB and intravenous diclofenac to reduce postoperative morphine consumption after breast surgery. Methods: Forty-four patients undergoing unilateral mastectomy under general anesthesia were randomly allocated into two groups: group PG (n=22) received TPVB using 0.25% levobupivacaine or group NG (n=22) received diclofenac 150 mg intravenously. The primary outcome was consumption of morphine during the first 24 h postoperatively. Secondary outcomes were consumption of morphine within 48 h postoperatively, numerical rating scale at 24 h and 48 h postoperatively at rest and movement, and complications during the first 24 h postoperatively Background: Breast surgery is associated with postoperative pain, nausea, and chronic pain. Thoracic paravertebral block (TPVB) and diclofenac are analgesic adjuvant to manage postoperative pain. Objectives: To compare the efficacy of TPVB and intravenous diclofenac to reduce postoperative morphine consumption after breast surgery. Methods: Forty-four patients undergoing unilateral mastectomy under general anesthesia were randomly allocated into two groups: group PG (n=22) received TPVB using 0.25% levobupivacaine or group NG (n=22) received diclofenac 150 mg intravenously. The primary outcome was consumption of morphine during the first 24 h postoperatively. Secondary outcomes were consumption of morphine within 48 h postoperatively, numerical rating scale at 24 h and 48 h postoperatively at rest and movement, and complications during the first 24 h postoperatively

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