Comparison of Postoperative Analgesic Effectiveness of Erector Spinae Plane Block vs Thoracic Paravertebral Block for Elective Breast Surgery Under General Anesthesia in Selected Governmental Hospital, Addis Ababa; Prospective Cohort Study, December 20 -April 30, 2022/23
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Date
2023-07-19
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Addis Ababa University
Abstract
Breast surgery is one of the most common types of surgery done worldwide. Inadequate postoperative analgesia leads to serious medical problems.TPVB has been a commonly used nerve block technique for post-surgical analgesia for breast surgery. ESPB the recently introduced nerve block method for providing anti-pain after mastectomy is safer, easily performed, and provides an adequate level of sensory blockage
Objective: The objective of this research thesis was to compare postoperative analgesic effectiveness of erector spinae plane block vs thoracic paravertebral block for breast surgery, in selected governmental hospitals of Addis Ababa; a comparative prospective cohort study,2022/2023.
Methods: After ethical committee approval, a prospective cohort study was conducted among 66 patients who undergo breast surgery from December 20-2022 to April 30, 2023. Data were collected by structured questionnaire and collected data were entered into Epi data version 3.1 and transported to SPSS version 25. Categorical data were analyzed by chi-square while Continuous data were analyzed by student t-test and Mann-Whitney U test for parametric & non-parametric data respectively. Data were reported by mean and standard deviation , median and inter-quartile range (IQR) based on data normality. 80% power and 95% Confidence. Results were considered as statistical significant when p value is <0.05
Result:-A total of 33 patients were involved with 100% response rate shows that the mean duration of 1st analgesic request time was significantly longer in the ESPB group (7.36 ±1.168hr) compared to the thoracic paravertebral group(6.61±1.321 hr) with a p-value of 0.016. Total postoperative analgesic consumption and pain severity score were comparable across the group with p-value >0.05.
Conclusion & recommendation:-ESPB provides prolonged postoperative analgesia for breast surgery and using it as a postoperative pain management plan improves patient satisfaction compared with TPVB.We would like to recommend setups that lack strong opioids for postoperative pain management should do ESPB for elective breast surgery as a post-operative pain management plan.
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Postoperative Analgesic Effectiveness of Erector Spinae Plane Block vs Thoracic