Preincisional ipsilateral stellate ganglion block for acute post operative pain control in unilateral mastectomy

Abstract

Objective: To evaluate the effect of preincisional ipsilateral stellate ganglion block for acute post operative pain control in unilateral mastectomy. Methodology: In a randomized clinical trial, 62 patients selected for unilateral mastectomy were recruited in Tabriz Imam Reza educational Hospital during 18- month period. They were randomly divided into two equal groups; receiving either preincisional ipsilateral stellate ganglion block using bupivacaine (study group) or without these blocks (control group). Postoperative pain was evaluated based on visual analogue scale (VAS). The total dose of analgesics were also compared between the two groups. Results: Thirty one female patients with a mean age of 48.7 +/- 74 (36- 60) years and 31 other female patients with a mean age of 50.7 +/- 6.9 (36- 60) years were enrolled in the study and control groups, respectively (p= 0.292). The number of patients with decrease in postoperative pain was significantly higher in the case study group comparing with that of the control group (p< 0.001). Decrease in total dose of postoperative analgesics was also significantly lower in the case study group compared with control group (P<0.001). Forty eight hours after operation, there were 15 pain-free patients in the study group with no pain-free patients in the control group. This difference was statistically significant (P<0.001). Conclusion: Based on our findings, the preincisional ipsilateral stellate ganglion block is an effective method in controlling the postoperative pain after unilateral mastectomy. This approach had also got a considerable analgesic- sparing effect.