COMPARISON OF POSTOPERATIVE ANALGESIC EFFICACY AND HAEMODYNAMIC STABILITY OF THORACIC EPIDURAL BLOCK VERSUS THORACIC PARAVERTEBRAL BLOCK USING CONTINUOUS INFUSION OF BUPIVACAINE IN PATIENTS UNDERGOING ELECTIVE MODIFIED RADICAL MASTECTOMY.

Introduction : Breast cancer is one of the most common cancers in women,requiring frequent surgical intervention. Adequate painrelief with parenteral and regional anaesthesia techniques improves respiratory outcome and decreases postoperative complications. Aim: To compare the postoperative analgesic efficacy and safety profile of thoracic epidural and thoracic paravertebral block using continuous infusion of bupivacaine in patients undergoing elective modified radical mastectomy. Materials and methods: A prospective randomized double-blinded study was conducted in 60 patients undergoing modified radical mastectomy under general anesthesia.30 patients in Group P received paravertebral block at T6-T7 level and 4 cm of catheter was directed cephalad,30 patients in group E received epidural block at T6-T7 level and 4 cm of catheter was directed cephalad .After extubation, the 0.125% bupivacaine infusion started, postoperative pain VAS score, haemodynamics and need for rescue analgesics observed and recorded Results:The statistical analysis showed that better hemodynamic stability was maintained in group P. However, in both the group P and group E postoperative analgesic efficacy was equally comparable. Conclusion:This study concludes that both thoracic epidural and thoracic paravertebral block provide comparable post operative analgesia in patients undergoing elective major breast surgery