Ultrasound guided thorasic paravertebral block for breast surgery in a patient with severe cardiopulmonary disease

Thorasic paravertebral block (PVB) thorasic epidural and pectoral nerve blocks can be used as a regional anesthetic option for breast surgery. Thorasic PVB is defined as injection of local anesthesthetic solution at the site where spinal nerves emerges from paravertebral foramen. It produces unilateral motor, sensory and sympathetic block, hence PVB could be an anesthetic choice in patients with severe cardiopulmonary disease. We report a case of an 78 year old patient with severe cardiopulmonary disease undergoing simple mastectomy by thorasic paravertebral block without any hemodynamic or respiratory derangement during perioperative period. In high risk patient, the use of PVB provides hemodynamic and respiratory stability with satisfactory anesthetic and analgesic efficacy