Paravertebral Catheter For Three-Level Injection In Radical Mastectomy And Its Effects On Post-Mastectomy Pain Syndrome

Objective: compare the profit of paravertebral catheter for three-level injection via catheter combined with general anesthesia and general anesthesia using in modified radical mastectomy,and evaluate the value of this technique using in Modified radical mastectomy.Methods: Patients were randomly divided into paravertebral block group(TPVB)and general anesthesia group(GA).TPVB group received paravertebral block via catheter and injections at three different levels combined with propofol intravenous anesthesia,while GA group using laryngeal mask general anesthesia.Record(1)sufentanil consumption,the duration of surgery,anesthesia recovery time and the extubation time;(2)pain scores on movement/at rest(including discharging PACU,the postoperative 4h,8h,12 h,24h,48h);pain scores,pain sites,and PMPs rates on movement /at rest 3 and 6 months after surgery;(4)Short-form Mc Gill Pain Questionnaire(SF-MPQ)scores before surgery and 48 h,3 months,6 months after surgery.(5)examined the correlation between perioperative pain and SF-MPQ score of 3 months and 6 months after surgery.Results:(1)The consumption of sufentanil,the recovery and extubation time of TPVB group were significantly smaller or shorter than that of GA group(p<0.05),there was no significant difference in the duration of surgery and propfol consumption between the two groups(P > 0.05);(2)Perioperative pain score:in addition to postoperative 12 h at rest and 8h on movement(P > 0.05),TPVB group at other time points' VAS scores were lower than the GA group(p<0.05).(3)Chronic pain: Except for 6 months at rest after surgery,there was no difference in VAS score between the two groups(P >0.05).VAS scores of 3?6 months after surgery in the TPVB group were lower than those in the GA group both at rest/on movement(P < 0.05).There was no significant difference in the incidence of PMPS between the two groups(P > 0.05).(4)Short-form Mc Gill Pain Questionnaire(SF-MPQ)scores:the SF-MPQ scores of 48 h,3 months and 6 months after surgery in TPVB group were significantly lower than those in GA group(P < 0.05);(5)The VAS scores of 4h,8h and 12 h in the two groups were correlated with the SF-MPQ score at 3 months and 6 months,in addition,the VAS score of 24 h in the GA group was correlated with the SF-MPQ score at 6 months.Conclusion: paravertebral block via catheter and injections at three different levels for modified radical mastectomy of breast cancer,not only can significantly reduce sufentanil consumption,improve the perioperative pain,shorten the recovery time of anesthesia,extubation time,also can significantly reduce the severity of PMPS,improve the quality of life of patients after surgery.