Upper Thoracic Epidural vs General Anaesthesia for MRM surgeries

Abstract

Background: Most preferred technique for Breast Cancer surgeries is general anaesthesia. Recently Thoracic Epidural anaesthesia has been used for these surgeries and has a advantage over General Anesthesia. Objective: We compared the two techniques for MRM surgeries. Material and Methods: Sixty ASA I II patients undergoing MRM surgery were randomly chosen in two study groups. In Thoracic Epidural (T) group epidural catheter was inserted at T1-T2 level and 10ml of 0.25% of Bupivacaine was given along with 6ml of 2% lignocaine. In GA group (G) routine general anaesthesia was administered with propofol, vecuronium, Fentanyl, with maintained on isoflurane, oxygen and nitrous. We compared adequacy of anaesthesia, surgical condition, post anaesthetic recovery, post anaesthetic analgesia and patient satisfaction. Results: Intraoperative Haemodynamic was comparable in two groups. Incidence of post operative nausea vomiting was less in epidural group (13.3%) in group T and ( 36.6%) in group G. Aldrete recovery score was better in 1^st hr in group T patients versus patients in group G. Patients satisfaction was a slightly higher in group G. Surgeons were satisfied with both methods. Conclusion: From our study we concluded that plain Thoracic Epidural for MRM surgeries provide adequate operating condition, less side effects better pain management and satisfaction.