title: General anesthesia with thoracic paravertebral block for modified radical mastectomy.
abstract: 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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  PVB can reduce postoperative opioid requirement, pain, and severity of nausea and vomiting in MRM.
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. preeyaphan@hotmail.com
authors.forename: Preeyaphan
authors.initials: P
authors.lastname: Arunakul
authors.forename: Acksara
authors.initials: A
authors.lastname: Ruksa
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000932:Antiemetics / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000601:surgery*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000150:complications / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000932:Antiemetics; D009020:Morphine; D002045:Bupivacaine