Purpose of review: Paravertebral blocks are becoming increasingly popular, especially as an anesthetic adjunct for breast procedures. New reports suggest additional reasons for adding this block to the anesthetic armamentarium.
Recent findings: Recent studies demonstrate a benefit from preoperative placement of a paravertebral block, not only in reducing acute postoperative pain, but also statistically significant reductions in the percentage of patients that develop chronic postsurgical pain 1 year after surgery. Another study found that the breast-cancer recurrence rate at 36 months after surgery was lower in the paravertebral group compared with the general anesthesia-only group of patients.
Summary: Paravertebral blocks are a well established option to provide anesthesia and postoperative analgesia during breast surgery. Recent studies suggest additional benefits to this procedure. Not only is acute pain better controlled, but the development of chronic mastectomy pain syndrome and recurrence of cancer may be reduced by preoperative placement of paravertebral block. These studies provide additional reasons why this block should be considered as part of the anesthetic for breast surgery.