الفهرس 
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Abstract
Acute pain management is an important aspect of perioperative anesthetic care. Inadequate postoperative analgesia has been shown to contribute to adverse outcomes including, but not limited to, immuno-suppression, hyperglycemia, poor rehabilitation, and progression to chronic pain.
This study compared the intraoperative haemodynamics and postoperative recovery profile and analgesia while using ultrasound guided paravertebral block versus thoracic epidural block in patients undergoing breast surgery.
The present study was performed on 60 adult female patients aged 40-60 years old from American society of Anesthesiology (ASA) physical status I-II scheduled for elective unilateral mastectomy under general anesthesia were allocated into two groups 30 patients each. The patients were divided into two groups, group (A): 30 patients were given single shot ultrasound guided paravertebral block at T4 level using 0.3 ml/kg of 0.5% bupivacaine. group (B): 30 patients were given single shot epidural block at T4 level using 2ml/segment of 0.5% bupivacaine.
It is found that ultrasound guided paravertebral block is more effective in postoperative pain management after mastectomy than thoracic epidural block. It maintains intraoperative hemodynamic stability and provides postoperative analgesia. It decreases incidence of complications associated with the use of opioids as it decreases PONV, length of stay in the hospital. It also reduces the requirement for postoperative analgesia in patients undergoing any breast surgery.