Comparative Study Between Thoracic Segmental Block and Thoracic Paravertebral Block in Mastectomy Surgery

Open Access

Abstract

Background: Postoperative pain after mastectomy is often inadequately controlled with systemic analgesics alone. Regional anesthetic techniques, including thoracic segmental block (TSB) and thoracic paravertebral block (PVB), may improve analgesia. This study compared their block characteristics, postoperative analgesic efficacy, and complication profiles. Methods & Materials: This comparative analytical study was conducted n the Department of Anaesthesia, Rangpur Medical College Hospital, Rangpur, Bangladesh, from January 2023 to December 2023 and comprised 60 female patients undergoing mastectomy, divided into two groups of 30 patients each (TSB and PVB). The two groups were compared with respect to sociodemographic and clinical variables, block-related characteristics, postoperative pain scores at 1, 6, 12, and 24 hours, and analgesic requirement and recovery outcomes. Data were entered and analyzed using SPSS version 26. Results: No major differences have been found between the two groups in age, residence, occupation, ASA status, BMI, comorbidities, or surgical characteristics. The success rate was high in both groups (93.3% TSB vs 90% PVB). TSB was associated with quicker block time (≤10 minutes in 73.3% compared with 43.3%), higher patient satisfaction (86.7% vs 70%), and reduced need for supplemental intraoperative analgesics (16.7% vs 26.7%). TSB had lower pain scores at all postoperative time points. The time to first rescue analgesia was significantly longer in TSB patients (60.0% vs 30.0%, OR 3.50, p = 0.021), and fewer TSB patients required multiple doses of rescue analgesia (23.3% vs 53.3%, OR 3.75, p = 0.019). TSB had a higher level of satisfaction with its patients than did the other banks (86.7% compared to 70%). Conclusions: TSB achieved a quicker onset of block, greater patient comfort, and longer, effective postoperative analgesia than PVB in mastectomy surgery, while maintaining a similar safety profile.