The Comparison of Postoperative Analgesic Efficacy of Ultrasound-Guided Paravertebral Block and Mid-Point Transverse Process Pleura Block in Mastectomy Surgeries: A Randomized Study.

Purpose/aim of the study: The purpose of this triple-blind randomized study is to compare the postoperative analgesic efficacy of Mid-Point Transverse Process Pleura Block (MTP) and Paravertebral Block (PVB) in patients undergoing breast surgery.

Materials and methods: The study was retrospectively registered on ClinicalTrials.gov (NCT05332028). A total of 64 patients undergoing unilateral simple mastectomy operation due to breast cancer were included in the study. Before the anesthesia procedure, participants were randomly assigned to one of two groups: Group 1: Participants undergoing PVB or Group 2: Participants undergoing MTP block. All block applications were performed using 20 mL of 0.25% bupivacaine. Routine general anesthesia protocol was performed on all patients. In the postanesthetic care unit, fentanyl infusion was given to all patients postoperatively via a patient-controlled analgesia device. Postoperative fentanyl consumption, time to the first request for analgesia, VAS score values at rest and in motion, and blocked dermatome areas were recorded.

Results: Postoperative total opioid consumption, the number of patients given rescue analgesia, the time requiring postoperative supplemental analgesia, postoperative pain scores at rest and in motion, and blocked dermatome areas at both anterior and posterior lower and upper limits were not different between groups (p > 0.05, for all).

Conclusions: It was concluded that ultrasound-guided PVB and MTP blocks have similar postoperative analgesic efficacy in patients undergoing breast surgery. The MTP block may be preferred as an alternative to PVB for breast surgeries with less risk of complications.