TY - JOUR
T1 - Effects of paravertebral blocks versus liposomal bupivacaine on hospital utilization after mastectomy with reconstruction
AU - Mohan, Srivarshini Cherukupalli
AU - Siegel, Emily
AU - Tran, Hai
AU - Ozcan, Lerna
AU - Alban, Rodrigo
AU - Shariff, Sashah
AU - Mirocha, James
AU - Chung, Alice
AU - Giuliano, Armando
AU - Dang, Catherine
AU - Anand, Kapil
AU - Shane, Rita
AU - Amersi, Farin
N1 - Funding Information:
The authors would like to acknowledge the National Center for Advancing Translational Sciences (NCATS) Grant UL1TR001881-01 (7/1/16–5/31/21) for its support for the statistical analyses presented here.
Publisher Copyright:
© 2022
PY - 2022/9
Y1 - 2022/9
N2 - Introduction: Inadequate pain control frequently extends length of stay (LOS) and costs for patients undergoing mastectomy with implant-based reconstruction (IBR). We sought to examine the effects of Paravertebral blocks (PVB) and liposomal bupivacaine (LB) and compare LOS, pain scores and costs of hospitalization. Methods: Prospective database review of patients undergoing mastectomy with IBR was performed. Results: 541 patients were identified. 51/491 (9.4%) received PVB and 50 (9.2%) received LB. LOS in the PVB group was significantly less than that of the no block (NB) group (1 [1–2] days PVB vs 3 [2–4] days NB (p < 0.0001), but was not different from the LB group (1 [1–2] days LB, p = 0.23). PVB patients had lower PACU pain scores compared to NB patients (3.2 ± 2.9 PVB vs 5.7 ± 2.6 NB, p < 0.0001), but similar PACU pain scores to LB patients (4.1 ± 2.3). Patients who received PVB had higher total costs compared to NB patients ($27148±$7053 PVB vs $23113 ± 6860 NB, p = 0.003) but similar to LB patients ($26183 ± $3761). Conclusion: PVB and LB are associated with shorter LOS and lower pain scores compared to NB.
AB - Introduction: Inadequate pain control frequently extends length of stay (LOS) and costs for patients undergoing mastectomy with implant-based reconstruction (IBR). We sought to examine the effects of Paravertebral blocks (PVB) and liposomal bupivacaine (LB) and compare LOS, pain scores and costs of hospitalization. Methods: Prospective database review of patients undergoing mastectomy with IBR was performed. Results: 541 patients were identified. 51/491 (9.4%) received PVB and 50 (9.2%) received LB. LOS in the PVB group was significantly less than that of the no block (NB) group (1 [1–2] days PVB vs 3 [2–4] days NB (p < 0.0001), but was not different from the LB group (1 [1–2] days LB, p = 0.23). PVB patients had lower PACU pain scores compared to NB patients (3.2 ± 2.9 PVB vs 5.7 ± 2.6 NB, p < 0.0001), but similar PACU pain scores to LB patients (4.1 ± 2.3). Patients who received PVB had higher total costs compared to NB patients ($27148±$7053 PVB vs $23113 ± 6860 NB, p = 0.003) but similar to LB patients ($26183 ± $3761). Conclusion: PVB and LB are associated with shorter LOS and lower pain scores compared to NB.
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U2 - 10.1016/j.amjsurg.2022.04.021
DO - 10.1016/j.amjsurg.2022.04.021
M3 - Article
C2 - 35504750
AN - SCOPUS:85130007823
SN - 0002-9610
VL - 224
SP - 938
EP - 942
JO - American journal of surgery
JF - American journal of surgery
IS - 3
ER -