{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:21:15Z","timestamp":1787775675678,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4]]},"abstract":"\n Background:<\/jats:title>\n Various regional anaesthetic techniques are used for post-mastectomy pain relief; however, thoracic paravertebral block (TPVB) has shown some advantages over other methods. This study sought to demonstrate the post-operative benefit of pre-operative TPVB in patients scheduled for simple mastectomy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The study was carried out on 60 adult female patients with the American Society of Anesthesiologists physical status Class I to III scheduled for unilateral mastectomy. Pre-operatively, a nerve stimulator was used to locate the paravertebral space thereafter bupivacaine with adrenaline or saline was injected into the space. Post-operatively, intravenous morphine patient controlled analgesia was commenced in the two groups for 24 h after the surgery. In addition, intravenous paracetamol 15 mg\/kg was administered 6 hourly for 24 h in both groups.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The 24 h morphine consumption was significantly reduced in the bupivacaine group compared to the control group (\n P<\/jats:italic>\n = 0.000). The Numerical pain rating score was significantly lower in the bupivacaine group than in the control group in the 1\n st<\/jats:sup>\n 6 h;\n P<\/jats:italic>\n = 0.001. The time to first request for analgesia was significantly longer in the bupivacaine group than the control group (\n P<\/jats:italic>\n = 0.000). Nausea was the major side effect detected and this was significantly higher in the control group (\n P<\/jats:italic>\n = 0.024). The morphine sparing effect was 65.7% in the bupivacaine group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The study showed that bupivacaine-based TPVB provided an effective post-operative analgesic and opioid-sparing effect for simple mastectomy when compared with a saline-based control group that received only intravenous morphine patient controlled analgesia and paracetamol.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/npmj.npmj_460_21","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T07:47:50Z","timestamp":1633938470000},"page":"102-107","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Analgesic and Opioid Sparing Effects of Preoperative Thoracic Paravertebral Block"],"prefix":"10.4103","volume":"28","author":[{"given":"Nnaemeka Ugonna","family":"Okoye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetinuwe A.","family":"Majekodunmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iniabasi U.","family":"Ilori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20240908","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4103\/1117-6806.127111","article-title":"Breast lumps: A 21-year single-center clinical and histological analysis","volume":"20","author":"Njeze","year":"2014","journal-title":"Niger J Surg"},{"key":"R2-5-20240908","first-page":"252","article-title":"An audit of excised breast lump in Ghanaian Women","volume":"24","author":"Ohene-Yeboah","year":"2005","journal-title":"West Afr J Med"},{"key":"R3-5-20240908","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/S0140-6736(19)30854-2","article-title":"Optimal post-operative pain management-redefining the role of opioids","volume":"393","author":"Hollman","year":"2019","journal-title":"Lancet"},{"key":"R4-5-20240908","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1093\/bja\/aeq265","article-title":"Efficacy and safety of paravertebral blocks in breast surgery: A meta-analysis of randomized controlled trials","volume":"105","author":"Schnabel","year":"2010","journal-title":"Br J Anaesth"},{"key":"R5-5-20240908","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4102\/safp.v60i3.4877","article-title":"An update on available pain medications","volume":"60","author":"Osuch","year":"2018","journal-title":"S Afr Fam Pract"},{"key":"R6-5-20240908","first-page":"450","article-title":"Intercostal nerves block for mastectomy in two patients with advanced breast malignancy","volume":"98","author":"Kolawole","year":"2006","journal-title":"J Natl Med Assoc"},{"key":"R7-5-20240908","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/AAP.0000000000000163","article-title":"Pectoral nerves I and II block in multimodal analgesia for breast cancer surgery \u2013 A randomized clinical trial","volume":"40","author":"Bashandy","year":"2015","journal-title":"Reg Anesth Pain Med"},{"key":"R8-5-20240908","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2147\/LRA.S116102","article-title":"Single-shot lamina thoracic paravertebral block with ketofol for modified radical mastectomy","volume":"9","author":"Rukewe","year":"2016","journal-title":"Local Reg Anesth"},{"key":"R9-5-20240908","doi-asserted-by":"crossref","first-page":"27","DOI":"10.4103\/0019-5049.93340","article-title":"Multiple-injection thoracic paravertebral block as an alternative to general anaesthesia for elective breast surgeries: A randomised controlled trial","volume":"56","author":"Das","year":"2012","journal-title":"Indian J Anaesth"},{"key":"R10-5-20240908","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/0253-7176.116232","article-title":"How to calculate sample size for different study designs in medical research?","volume":"35","author":"Charan","year":"2013","journal-title":"Indian J Psychol Med"},{"key":"R11-5-20240908","first-page":"R464","article-title":"The role of paravertebral block in decreasing postoperative pain in elective breast surgeries","volume":"13","author":"Dabbagh","year":"2007","journal-title":"Med Sci Monit"},{"key":"R12-5-20240908","first-page":"1184","article-title":"Somatic paravertebral nerve blockade","volume":"56","author":"Naja","year":"2001","journal-title":"Incidence of failed block and complications. 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