In a limited number of patients, we found that PVB is superior to direct surgical infiltration of ropivacaine for bilateral breast augmentation in same-day surgery. These advantages need to be balanced against the potential risks of PVB, especially in an office setting.
Breast surgery is most commonly conducted for a suspected diagnosis or treatment of cancer. Additionally, cosmetic breast surgery is an increasingly common field particularly in the day-case setting. Both oncological and plastic surgery of the breast varies in site, extent of dissection, surgical technique, and duration of procedure in the context of diverse patient factors (premorbid psychosocial profile, physical habitus, tissue quality, comorbidities). These elements all require careful consideration for the attending anaesthetist and surgical team in order to optimize the patient journey through their recovery in both the acute and long-term periods. In addition to systemic administration, improved postoperative analgesia and subsequent recovery in breast surgery incorporates regional and local anaesthetic techniques. Integral to any surgical setting is a patient-specific pain management plan. This should commence at the time of anaesthesia and continue into the postoperative period. Any risk factors for chronic pain need to be identified and managed early.
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