General anesthesia with thoracic paravertebral block for modified radical mastectomy.

OBJECTIVE To evaluate the effect of single-injection paravertebral block (PVB) combined with general anesthesia on 24-hour postoperative morphine requirement in patients undergoing modified radical mastectomy (MRM). MATERIAL AND METHOD 20 patients were randomly assigned into 2 groups. Patients in the control group were given only general anesthesia. Patients in the PVB group received 0.3 ml/kg of 0.5% plain bupivacaine at T4 paravertebral space followed by general anesthesia. Both groups received intravenous morphine patient-controlled analgesia (PCA) device postoperatively. All patients were evaluated at 1 and 24 hours for pain, nausea and vomiting. Twenty-four hour morphine consumption, antiemetics requirement, and overall satisfaction were recorded. RESULTS Patients with PVB had lower incidence and severity of postoperative pain, nausea and vomiting and other serious complications. No patients were unsatisfied with anesthetic techniques. CONCLUSION PVB can reduce postoperative opioid requirement, pain, and severity of nausea and vomiting in MRM.