Jakkula Kishore1, Satya Srinivas P2, Tadepalli V. N. Sarat Chandu3, Kamesh P4
BACKGROUND
In earlier days General Anaesthesia (GA) was the choice for MRM, but recently Thoracic Epidural (TE) analgesia is being increasingly used for MRM. TE technique has a lot of advantages over the conventional GA technique.
MATERIALS AND METHODS
100 patients with carcinoma breast are divided into two groups- Thoracic Epidural (TE) and General Anaesthesia (GA) of 50 patients each. Four patients in TE group were converted to GA in view of patient’s anxiety during surgery. All the intraoperative parameters heart rate, blood pressure, bleeding and postoperative outcomes, seroma formation, drains, wound infection rates, flap necrosis and hospital stay are recorded.
RESULTS
The demographic data showed no differences between both groups. During the intraoperative period, hypertension and tachycardia were more frequent in GA group while hypotension and bradycardia more in TE group, which was statistically significant (p value <0.05). In the immediate postoperative period, nausea and vomiting were more in GA group (31%) than in TE group (8.6%), which was statistically significant (p value 0.01). Also, pain scores were more in GA group than in TE group. Wound infection rates, seroma incidence, flap necrosis, length of hospital stay and hospital costs were less in TE group than GA group.
CONCLUSION
Use of thoracic epidural technique as a sole anaesthetic technique for MRM surgeries provides adequate operating conditions, better side effect profile, better pain management, less postoperative complications, early ambulation, early drain removal and early discharge from the hospital.
KEYWORDS
MRM, Thoracic Epidural, General Anaesthesia.
