Single-injection paravertebral block before general anesthesia enhances analgesia after breast cancer surgery with and without associated lymph node biopsy.

摘要: Paravertebral block (PVB) seems to decrease postoperative pain and nausea vomiting (PONV) after breast surgery, but the studies have not been placebo controlled. We studied 60 patients scheduled for cancer surgery randomly given single-injection PVB at T3 with bupivacaine 5 mg/mL (1.5 mg/kg) or saline before general anesthesia. The patient attending investigators were blinded; sham was performed behind a curtain by an anesthesiologist involved in study. needed 40% less IV opioid medication (primary outcome variable) postanesthesia care unit, had longer latency first dose, rest 24 h than control (P < 0.01). They also PONV unit 0.05), sedated until 90 min better digit symbol substitution test ocular coordination 60-120 0.05). average peak plasma concentration 750 ng/mL. One bilateral convulsions immediately injection. conclude that anesthesia reduced pain, consumption, occurrence of improved recovery from