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Khirurgii

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Year 2015 Vol. 23 No 6

ANESTHESIOLOGY-REANIMATOLOGY

V.V. YASKEVICH¹, A.V. MAROCHKOV²

PARAVERTEBRAL BLOCKS AS A COMPONENT OF ANESTHETIC MANAGEMENT OF BREAST CANCER SURGERY

ME "Bobruisk Interdistrict Oncologic Dispensary"¹,
ME "Mogilev regional hospital"²,
The Republic of Belarus

Objectives. Increase of efficiency and safety of the multicomponent balanced endotracheal anesthesia in the combination with paravertebral block for surgical interventions in patients with breast cancer.
Methods. Two groups of patients were formed. In the 1st group (n=30) the multicomponent balanced endotracheal anesthesia was applied. In the 2nd group (n=27) the multicomponent balanced endotracheal anesthesia with paravertebral block (PVB) was applied. Paravertebral block was performed under ultrasound-guided surgery navigation at the Th1, Th2, Th3, Th4, Th5 and Th6 levels. At each level 1,5 mL of a local anesthetic (0,75% ropivacaine solution) was injected to patients, the total volume was 9 mL. In five cases the block was performed using 2 mL of a local anesthetic (0,75% ropivacaine solution) at each level and the total volume of 12 mL.
Results. During the operation the patients of the 1st group required more fentanyl than did those in the 2nd group; so as in the 1st group droperidol consumption was more than in the 2nd group. Neither pneumothorax nor any other complications were encountered after PVB. Postoperative reduced need for analgesics in patients of the 2nd group was marked only in the first day after surgery.
Conclusion. The present method of the spinal nerves PVB at the level Th1-Th6 with small doses of local anesthetic (administered ropivacaine at 0,75% (1,5 mL) at the level) as a component of the combined anesthesia for breast cancer surgery in the volume of radical mastectomy gives safe and effective pain relief. This method reduces the risk of systemic toxicity of local anesthetics. Application of small doses of local anesthetics for thoracic paravertebral block has been show to reduce patient need for analgesics in the first day after surgery.

Keywords: paravertebral block, breast cancer, mastectomy, breast surgery, surgical anaesthesia, ropivacaine solution, safe and effective pain relief
p. 666-672 of the original issue
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Address for correspondence:
213825, Republic of Belarus,
Mogilevskaya oblast,
Bobruysk, per. Sosnovyiy, d. 40,
UZ "Bobruyskiy mezhrayonnyiy
onkologicheskiy dispanser",
tel.mob.: 375 029 601-94-21,
e-mail: varera@tut.by,
Yaskevich Valeriy Viktorovich
Information about the authors:
Yaskevich V.V. An anesthesiologist-resuscitator of ME "Bobruisk Interdistrict Oncologic Dispensary".
Marochkov A.V. MD, a head of the anesthesia and resuscitation unit of ME "Mogilev regional hospital".
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