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Regional Anesthesia and Acute Pain: Original Articles
The impact of paravertebral block analgesia on breast cancer survival after surgery
  1. Juan P. Cata, MD*,†,
  2. Mariana Chavez-MacGregor, MD‡,
  3. Vicente Valero, MD‡,
  4. Walter Black, BS*,†,
  5. Daliah M. Black, MD§,
  6. Farzin Goravanchi, MD*,
  7. Ifey C. Ifeanyi, MD*,
  8. Mike Hernandez, MS∥,
  9. Andrea Rodriguez-Restrepo, MD*,† and
  10. Vijaya Gottumukkala, MD*
  1. *Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center
  2. †Anesthesiology and Surgical Oncology Research Group
  3. ‡Departments of Breast Medical Oncology
  4. §Breast Surgical Oncology
  5. ∥Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
  1. Address correspondence to: Juan P. Cata, MD, Department of Anesthesiology and Perioperative Medicine, The University of Texas-MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (e-mail: jcata{at}mdanderson.org).

Abstract

Background and Objectives The impact of regional anesthesia on breast cancer recurrence is controversial. We tested the hypothesis that the use of paravertebral block (PVB) analgesia during breast cancer surgery prolongs the recurrence-free survival (RFS) and overall survival (OS) of women with breast cancer.

Methods Seven hundred ninety-two women with nonmetastatic breast cancer were included in this retrospective study. Patients were divided based on the administration of PVB analgesia for mastectomy surgeries. One hundred ninety-eight (25%) were given a PVB, the remainder were treated with opioid-based analgesia. Propensity score matching was developed using several variables. Univariate and multivariate analyses were used to assess the impact of PVB analgesia on RFS and OS.

Results The median follow-up times for RFS and OS were 5.8 and 6 years, respectively. In the propensity score matching model, a total of 396 women were included in each group of treatment (non-PVB group, n = 198 vs PVB group, n = 198). As expected, the fentanyl consumption was significantly lower in PVB (122.8 ± 77.85 μg) patients than non-PVB subjects (402.23 ± 343.8 μg). Other variables were not statistically significant. After adjusting for several important covariates, the analysis indicated that the use of PVB is not associated with a significant change in RFS [1.60 (0.81–3.16), P = 0.172] or OS [1.28 (0.55–3.01)] survival.

Discussion This retrospective study does not support the hypothesis that the use of regional analgesia is associated with longer survival after surgery for breast cancer.

https://doi.org/10.1097/AAP.0000000000000479

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    Footnotes

    • The authors declare no conflict of interest.

      This work was supported in part by the Cancer Center Support Grant (CCSG) NCI P30 CA016672.