Date Posted: June 9, 2026

Author/s: Nicole Avenido, MD

In the majority of breast surgeries performed in this institution, general anesthesia is employed with concomitant endotracheal intubation. In other countries, thoracic paravertebral block has been popularly used in thoracic and abdominal surgeries due to its various advantages. Ultrasound-guided techniques is the gold standard in performing peripheral nerve blocks, allowing anesthesiologists to accurately identify the target nerve and monitor the distribution of the anesthetic in real time, which results to a higher success rate and less complications. In institutions where there are limited resources, especially in training institutions, the utilization of an electrical nerve stimulator can be an alternative means to allow the anesthesiologist to make precise correlations between the anatomy, physiology and clinical effect which can be appreciated instantaneously upon induction, and to precisely identify only the specific nerves that need to be targeted. It is a principal component of an anesthesiologist’s arsenal to be adept at performing various techniques to alleviate pain even in situations where latest technological advance is lacking. This is a case of an 85-year-old female with an 8cm x 8cm mass on her right breast who successfully underwent modified radical mastectomy under thoracic paravertebral block with intravenous sedation.

Keywords:
Thoracic Paravertebral Block (TPVB), regional anesthesia, breast surgery, Peripheral Nerve Block (PNB), nerve stimulator