Background: To retrospectively compare the effects of general anesthesia (GA) and thoracic paravertebral block (TPVB) combined with general anesthesia on the incidence of hypotension and postoperative pain in breast cancer (BC) surgery.
Methods: We retrospectively collected the medical records of patients who underwent BC surgery under general anesthesia from January 2018 to December 2020, and divided them into 2 groups according to the patient's anesthesia management method: GA group (Group G) and TPVB combined with GA group (Group T). During the operation, the use of boosting drugs and ephedrine, amount of fluid infusion, amount of bleeding, and operation time of the 2 participant groups were recorded, as well as the pain score in the resting state.
Results: During anesthesia, the bispectral index (BIS) value of Group G was significantly lower than that of Group T, the use of sufentanil and the use rate of ephedrine were significantly higher than that of Group T, and the difference was statistically significant (P<0.05). At the T4 time point, the blood pressure [systolic blood pressure/diastolic blood pressure (SBP/DBP)] of Group G was higher than that of Group T; at time point T3, the blood pressure (SBP/DBP) of Group G was lower than that of Group T. At the T4 time point, the heart rate of G group was higher than that of Group T, and the heart rate of G group was lower than that of Group T at the time points T2 and T3. The difference between the 2 groups was statistically significant. The change trend of the visual analogue scale (VAS) scores of the 2 participant groups was basically the same when they were resting peacefully, and there were statistical differences in the VAS scores at 1, 2, 4, and 8 h after surgery (P<0.05).
Conclusions: When TPVB is combined with GA, there is a lower incidence of hypotension, more stable circulatory state, and better postoperative analgesic effect.
Keywords: Thoracic paravertebral block (TPVB); breast cancer; general anesthesia; hypotension; postoperative pain.