title: [Combined use of paravertebral block and general anesthesia for breast cancer surgery].
abstract: BACKGROUND
  Thoracic paravertebral block (TPVB) is reportedly a useful alternative of general anesthesia (GA) for patients undergoing major breast surgery. To provide surgical anesthesia by TPVB alone, however, demands considerable patient's discomfort during neural block and during surgery. This study was undertaken to investigate if TPVB adds to patient satisfaction when combined with GA for breast cancer surgery.
  
  
  METHODS
  In 26 women (ASA I * II) undergoing modified radical mastectomy with axillary dissection, TPVB was performed at T 1 level and 15 ml of 0.5% ropivacaine was injected prior to induction of general anesthesia. After surgery, VAS (visual analogue scale, 0-100 mm) pain scores and postoperative medication were recorded. These data with TPVB were compared with those of 17 patients who had previously undergone similar surgical procedure without TPVB in our hospital.
  
  
  RESULTS
  The VAS scores in patients with TPVB were 34 +/- 45 mm (mean +/- SD) on admission to the recovery room and 15 +/- 5 mm next morning. Frequency of postoperative administration of analgesics in patients with TPVB was significantly less than those without TPVB.
  
  
  CONCLUSIONS
  Above findings suggest that combined use of TPVB and GA may be a preferable choice of anesthesia for patients undergoing major breast cancer surgery.
authors.affiliation: Department of Anesthesia, Fukuyama City Hospital, Fukuyama 721 8511.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Ono
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Danura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Koyama
authors.forename: Hidekuni
authors.initials: H
authors.lastname: Hidaka
mesh_terms: D000577:Amides; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D000779:Anesthetics, Local; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015411:Mastectomy, Modified Radical; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D000077212:Ropivacaine; D013904:Thoracic Vertebrae
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine