Shah A (2015) [19]

Retrospective review involving 132 patients

Implant-based breast reconstruction

Intercostal nerve blockade

Significant reduction in length of stay, consumption of intravenous morphine and increased cost-savings


Sundarathiti P (2015) [20]

RCT involving 70 breast cancer patients

Unilateral mastectomy surgery with axillary dissection

GA or PVB via catheter and injections at 3 different levels

Analgesic consumption, post-operative pain scores significantly greater in patients with GA


Kulkarni K (2013) [21]

40 ASA I and II patients with breast cancer

Radical mastectomies

Cervical epidural anaesthesia with either 10 mls of 0.25% bupivacaine or 10 mls of 0.375% ropivacaine

Similar onset of sensory block

Significant increase in mean motor blockade score, time to achieve complete blockade and time to grade I motor recovery for patients who received bupivacaine

Respiratory distress in 2 patients requiring GA with intubation

Coopey SB (2013) [22]

Retrospective review of breast cancer patients

Mastectomies with immediate reconstructions


Significantly less mean length of stay, shorter mean time to conversion to oral narcotics, less incidence of PONV in PVB group


Li NL (2011) [23]

40 breast cancer patients

Unilateral breast surgery

GA or (GA and PVB)

Significantly lower pain scores at all time points, incidences of PONV, doses of postoperative analgesics and narcotics and higher Quality of Recovery scores in PVB group


Moller JF (2007) [24]

RCT involving 88 breast cancer patients

Breast tumour resection or mastectomy with lymph node biopsy

GA and paravertebral injections with either 0.5% ropivacaine or saline

Postoperative consumption of IV fentanyl and number of patients who reported pain >3 on NRS were significantly less in the Ropivacaine group


Singh AP (2006) [25]

50 ASA 1 or 2 breast cancer patients

Modified radical mastectomies

Cervical epidural anaesthesia with 10 mls of 1% lignocaine followed by 0.125% bupivacaine through epidural catheter

No clinically significant variations in perioperative pulse and respiratory rate

No fall in mean arterial blood pressure during operation

One case where the procedure was terminated due to accidental dura puncture.

Exadaktylos AK (2006) [26]

Retrospective study of 129 patients with breast cancer

Mastectomy and axillary clearance

50 patients had PVB with GA; 79 patients had GA with morphine analgesia

Recurrence- and metastasis-free survival was significantly higher in the PVB patients