Purpose of Technology: Patients undergoing breast surgery have a notable risk of developing persistent pain lasting for more than 3 months following the procedure. Paravertebral blocks (PVBs) may be used in breast surgery as part of anesthetic care, and have been linked to reduced acute postoperative pain.

Rationale: Given that increased acute pain is a notable risk factor for the development of chronic pain, there is interest in whether PVBs may be associated with reductions in longer-term postsurgical pain as well.

Controversy: While there is evidence that PVBs are associated with decreased short-term pain following breast surgery, it is unclear whether long-term pain outcomes are also improved. Furthermore, there are many techniques for PVB administration, and optimal protocols and patient selection criteria have not been established.

Relevant Questions:

  • In adults undergoing breast surgery, is PVB effective for preventing chronic postsurgical pain (lasting > 3 months), improving quality of life (QOL), and reducing postoperative analgesic use? 
  • How does PVB compare with sham and alternative treatments for preventing chronic postsurgical pain, improving QOL, and reducing postoperative analgesic use?
  • What complications are associated with PVB?
  • Have patient selection criteria been established for the use of PVB for prevention of chronic pain following breast surgery?

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