We evaluated whether paravertebral block (PVB) use altered opioid use, antiemetic use, and length of stay in patients undergoing mastectomy. Methods: We performed a retrospective cohort analysis of all patients who underwent mastectomy with or without PVB from 2008 to 2010.

Regional techniques may be useful for pain control after mastectomy, with paravertebral block (PVB) commonly used. Pectoral nerve block (PecNB) may offer improved analgesia, particularly in the axilla and upper limb. Improved pain relief and reduced morphine consumption were found with PecNB compared with PVB.

In this case report, we present a 33-year-old woman who underwent a successful modified radical mastectomy for stage IIIb breast cancer associated with clinical and radiological features of metastasis to the lung under a multiple injection landmark technique paravertebral nerve block.

CONCLUSIONS: Paravertebral block can be used to perform major operations for breast cancer with minimal complications and a low rate of conversion to general anesthesia. Paravertebral block markedly improves the quality of recovery after breast cancer surgery and provides the patient with the option of ambulatory discharge.

Thoracic paravertebral block may be used for analgesia after breast surgery. Ultrasound can be used during the whole technique of paravertebral block to increase success rate and decrease its complications. As well, pectoral nerve block is now used for pain relief after modified radical mastectomy with or without axillary clearance.