Purpose to compare paravertebral thoracic block (PVB) and pectorals nerves block as analgesic
option for major breast surgery.
102 patients undergoing reconstruction breast surgery will be randomized into two groups:
Group PVB (n=51) will receive US guided paravertebral thoracic block (between T2-T6)
performed with 30ml of 0.25% levobupivacaine before general anesthesia (TCI-TIVA) induction.
Morphine patient control analgesia (PCA) with loading dose i.v. titrated by the PACU nurse if
pain > 5/10 at rest Group PECS (n=51) will receive US guided pectorals nerves block performed
with 30ml of 0.25% levobupivacaine before general anesthesia (TCI-TIVA) induction.
Morphine PCA with loading dose i.v. titrated by the post-anesthesia care unit (PACU) nurse if
pain > 5/10 at rest
Primary Outcome Measures:
Morphine consumption (mg) (Time Frame: 24 hours) in two Groups
Secondary Outcome Measures:
Pain at rest and during movement quantified as Numerical Rating Scores (0-10) during the
first 24 hours postoperatively.
Eventual side effects such as nausea/vomiting. Time necessary to perform the procedure. Pain
during procedure execution quantified as Numerical Rating Scores (0-10) Hypnotic and opioids
intraoperative consumption to ensure general anesthesia with Bispectral Index between 40 and
60.