Abstract

Background: The retrolaminar approach of paravertebral block (PVB) is a recent approach which could replace the ordinary approach of PVB as it may have the same analgesic effect with decreased risk of side effects.

Study Objectives: This prospective randomized clinical trial aimed to compare the effect of retrolaminar and ordinary approach of PVB on postoperative analgesic profile after breast surgeries.

Design: Randomized clinical double-blinded trial.

Setting: Operative room, postoperative care unit, and follow-up clinic.

Methods: Sixty female patients scheduled for unilateral breast surgery under general anesthesia and PVB were randomly and equally distributed into two groups; group O, in which the patients received PVB by the ordinary approach, and group R, in which the patients received the PVB through retrolaminar approach.

Main outcome measures: The primary outcome was the total dose of morphine consumed in the first 24 hours after surgery and the secondary outcome was the incidence of complications.

Results: In comparison to the ordinary approach, the use of retrolaminar approach of PVB did not significantly change the postoperative morphine consumption (9 (9-6) mg versus (9 (9-6) mg P= 0.823) and did not significantly change the incidence of perioperative complications (P > 0.05). Also, it did not significantly affect the postoperative Numeric Metric Score (NRS) score (P > 0.05).

Conclusion: The retrolaminar approach of PVB has the same effect on the postoperative morphine consumption, the postoperative pain score, and the duration of postoperative analgesia as the ordinary approach in patients undergoing unilateral breast surgery without significant effect on the incidence of complications.

Trial registration: The study was registered at clinicaltrial.gov (ID; NCT04162951)