Analgesic efficacy of interpleural and paravertebral block
Research type
Research Study
Full title
A comparison of the analgesic efficacy of interpleural and ultrasound guided thoracic paravertebral block for mastectomy; A double blinded randomised trial
IRAS ID
147526
Contact name
Mritunjay Varma
Contact email
ISRCTN Number
ISRCTN13324055
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Paravertebral block and interpleural block are both regional anaesthetic techniques which provide numbness and pain relief over the chest on the side where the injection is performed. They are used in conjunction with a general anaesthetic, and at the RVI we perform them after the patient has been anaesthetised. Both have been shown to provide excellent pain relief for patients undergoing breast surgery with a low risk of complications. In Interpleural block, local anaesthetic is injected into between the pleura, these are two layers which line the lung. The local anaesthetic then spreads to block the nerves of the chest wall. This is a simple technique to learn and quick to perform. In a paravertebral block, local anaesthetic is injected into a small area alongside the spine called the paravertebral space through which most of the nerves to the chest wall run. In the past this was performed with a landmark technique but there was a failure rate of 10%. At the RVI we use ultrasound to locate the paravertebral space and the guide the needle under direct vision. This allows accurate placement of local anaesthetic but requires technical ultrasound skills which only a minority of anaesthetists currently possess. Two studies have demonstrated that a landmark paravertebral block and interpleural block provide similar analgesia in radical mastectomy and thoracic surgery. Our hypothesis is that ultrasound guided paravertebral block will provide better analgesia than interpleural block in patients undergoing simple mastectomy. We have chosen to include patients undergoing the same procedure to reduce the variability in pain due to the surgery. We aim to undertake a randomised trial comparing the two techniques to test our hyothesis.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
14/NE/1228
Date of REC Opinion
18 Dec 2014
REC opinion
Favourable Opinion