We report a case of 50 years old female diagnosed with carci noma of breast posted for modified radical mastectomy (MRM). Her comorbidities included diabetes mellitus (DM), hypertension, ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD). She was also anxious about postoperative analgesia. The surgery was successfully completed under general anesthesia (GA) with single level thoracic paravertebral block (PVB) using peripheral nerve stimulator (PNS). Regional techniques like PVB are preferred modalities for perioperative analgesia. It provides good intraoperative conditions with adequate postoperative analgesia with least hemodynamic alterations in high risk cases specially IHD.
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