Previous studies have shown that paravertebral block (PVB) has the potential to reduce pain and side effects after breast surgery when used in addition to general anesthesia or sedation.The investigators would like to further discern the impact of GA or PVB on the postoperative QoR, pain and satisfaction.

Inclusion Criteria:

• Patient has a physical status between ASA I and III
• Female
• 18 - 70 years of age
• Patients able to read a newspaper in Chinese.
• Elective unilateral wide excision/simple mastectomy and SLNB/ALND
• Patient has signed an informed consent
• Without contraindication of GA or PVB
• Body mass index (BMI) less than 24 kg/m2

Exclusion Criteria:

• ASA > III
• inability to provide informed consent
• Bleeding disorders
• Contraindications to nonsteroidal anti-inflammatory drugs (NSAIDs)
• Allergy to amide-type local anesthetics or NSAIDs
• Infection at the thoracic paravertebral injection site
• Pregnancy or breast-feeding
• Severe spine or chest wall deformity
• body mass index equal to or more than 24 kg/m2
• patients with major psychosis or drug and alcohol abuse
• patients with a history of significant neurological, psychiatric, neuromuscular, cardiovascular, pulmonary, renal or hepatic disease
• Patients with significant visual impairment or other physical disability that precludes complete cooperation