Paravertebral Blocks for Same-Day Breast Surgery

Abstract

In patients receiving PVB, immediate and long-term analgesia is superior to systemic analgesia while opioid use and typical adverse effects of systemic analgesia such as nausea and vomiting are decreased. The benefits may also include an improved oncological survival with PVB after mastectomy for malignancy. PVB offers clinically significant benefits for perioperative care of patients undergoing breast surgery. The benefits of continuous PVB are most firmly supported for major breast surgery and include both effective short-term pain control and reduction in burden of chronic pain. On the other hand, minor breast surgery should be effectively manageable using multimodal analgesia in the majority of patients, with PVB reserved as analgesic rescue or for patients at high risk of excessive perioperative pain.

Safety of Continuous Erector Spinae Catheters in Chest Trauma: A Retrospective Cohort Study

“…An example of this is the decision to perform a paravertebral block in elective cosmetic breast surgery. 25 While significant complications from this block are infrequent, some clinicians may still find the risk too high to justify it as part of their routine practice. 23 The erector spinae block is a valuable alternative to the paravertebral block, shown to have good efficacy in breast surgery.…”

Safety of Continuous Erector Spinae Catheters in Chest Trauma: A Retrospective Cohort Study

“…The decision to provide regional anaesthesia becomes less clear as patient risk related to systemic analgesia lessens. An example of this is the decision to perform a paravertebral block in elective cosmetic breast surgery [25]. While significant complications from this block is infrequent, some clinicians may still find the risk too high to justify it as part of their routine practice [23].…”

The Role of Paravertebral Blocks in Ambulatory Surgery: Review of the Literature

“…This method of administering local anaesthetics most commonly results in a prolonged unilateral anaesthesia as well as a possible lumbar PVB, depending on the dose and volume of anaesthetic ( 5 , 21 ). There are many studies stating the benefits of ambulatory breast surgery in only PVB or in combination with general anaesthesia ( 10 , 11 , 14 , 22 ). There is also a significantly present application of PVB in day surgery of inguinal hernia repair in both children and adults, in lithotripsy, video assisted thoracic surgery, gall bladder removal and chronic pain therapy ( 7 , 9 , 10 , 13 , 15 - 18 , 23 ).…”