Effects of paravertebral blocks versus liposomal bupivacaine on hospital utilization after mastectomy with reconstruction

Srivarshini Cherukupalli Mohan, Emily Siegel, Hai Tran, Lerna Ozcan, Rodrigo Alban, Sashah Shariff, James Mirocha, Alice Chung, Armando Giuliano, Catherine Dang, Kapil Anand, Rita Shane, Farin Amersi

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalAmerican journal of surgery
DOIs
StateAccepted/In press - 2022
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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