Comparison of Postoperative Pain Following Modified Radical Mastectomy under Thoracic Epidural Anesthesia versus General Anesthesia: A Randomized Control Trial.
Nitu Puthenveettil, Sundeep Vijayaraghavan, Sunil Rajan et al.
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In 30 seconds
This randomized controlled trial compared thoracic epidural anesthesia with general anesthesia using a laryngeal mask airway in 100 patients undergoing unilateral modified radical mastectomy. Postoperative pain scores were significantly lower with epidural anesthesia at all measured time points, and analgesic requirements were significantly higher with general anesthesia (P < 0.001). Hospital stay and intraoperative hemodynamics were comparable. Patients reported greater satisfaction with general anesthesia, while several airway-related symptoms and nausea and vomiting were more frequent in that group.
Key findings
- Postoperative pain scores were significantly lower with thoracic epidural anesthesia at all measured time points.
- Perioperative analgesic requirements were significantly higher with general anesthesia (P < 0.001).
- Patient satisfaction was significantly higher with general anesthesia, although surgeons were satisfied with both approaches.
- Sore throat, cough, hoarseness, nausea and vomiting, and ICU stay were reported as significantly higher in the general-anesthesia group.
Why it matters
The findings suggest that anesthetic approach may affect postoperative analgesia and recovery symptoms after modified radical mastectomy, while patient satisfaction may favor general anesthesia. Considering these differing outcomes can support informed discussion of anesthesia options, but the abstract does not establish that one approach is preferable overall.
What to keep in mind
The trial included 100 patients undergoing unilateral modified radical mastectomy; the abstract provides no effect sizes for pain or other outcomes, and does not report follow-up beyond the perioperative period.