Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anaesthesia and Pain Relief

Objectives: This study aimed at evaluating the feasibility of using paravertebral block as an isolated mode of anesthesia in cases undergoing MRM. Also it aimed at evaluating the efficacy of the TPVB with and without dexmedetomidine in pain management and opioid consumption while observing occurrence of complication. Patients and methods: The study included 150 patients, 111 ASA II patients and 39 ASA III patients. Patients were randomly divided into three equal groups: TPVB group included patients assigned to thoracic paravertebral block with pubivacaine program, TPVBD group included patients assigned to thoracic paravertebral block with pubivacaine and dexmedetomidine program and Control group included patients assigned to the traditional general anesthesia program. Haemodynamics were recorded for all groups as well as VAS score, opioid consumption, LOS in PACU and hospital and need for sedation for the first two groups. Results: There were significant differences between TPVB and TPVBD groups on one side and control group on the other side as regards the haemodynamics, VAS, opioid consumption and LOS in PACU denoting that the use of PVB is preferable, yet there was increased need for either sedation or general anesthesia in the TPVB and TPVBD groups specially on. Comparative study to show efficacy of thoracic paravertebral block, with and without. Dexmedetomidine, in modified radical mastectomies

Issued also as CD