Paravertebral Block, an Adjunct to General Anaesthesia for Breast Surgery?

Paravertebral Block, an Adjunct to General Anaesthesia for Breast Surgery?

Aim is to study if a paravertebral block as an adjunct to general anesthesia is a suitable technique for extended, one sided, breast surgery.

Usually breast tumour surgery in the Academic Hospital Maastricht is performed under general anaesthesia. Perioperative pain management consists of paracetamol and naproxen preoperatively, opioids during surgery and local wound infiltration at the end of surgery with 10cc Bupivacaine 0.25%. Postoperative pain management consists of paracetamol, occasionally combined with Naproxen, and if necessary Piritramide 0.2 mg/kg i.m.

Alternatively there is the possibility to perform breast surgery under a thoracic paravertebral block (PVB) with or without general anesthesia.

A PVB according to Eason and Wyatt (1) can be performed preoperatively with insertion of an end-hole catheter T3-T4. With this technique we expect a better pain relief postoperatively.

Inclusion Criteria:

• Extended mamma surgery one-sided
• ASA class I and II

Exclusion Criteria:

• All contra indications for local anaesthesia
• Coagulation disorders
• Infection
• Allergic reactions