Combined thoracic paravertebral block and interscalene brachial plexus block for modified radical mastectomy: A case report

Table 2 Timeline of the case series

Case series	Ten elderly and fragile patients with multiple comorbidities scheduled for modified radical mastectomy
Interventions	Standard monitoring and sedation with midazolam in lateral decubitus position before regional anesthesia. 10 and 15 mL of 0.5% ropivacaine injected at T2-T3 and T5-T6 as thoracic paravertebral block by ultrasound-guided using the out-of-plane technique.5 mL of 0.5% ropivacaine injected as interscalene brachial plexus block using the in-plane technique
Results	Sensory blockade assessed by pin prick testing, covering the region between the clavicle and T7 dermatome, and from the ipsilateral parasternal area to the axilla. Only sedated with propofol and oxygen supplementation via a nasal cannula during surgery. Vasopressors, narcotics or general anesthesia was not applied but considered if required for surgery
Follow-up	Postoperative pain was well controlled as a 2 out of 10 points pain score without celecoxib or morphine. Normal food intake was resumed within 4 h and surgical-side hand were able to use within 24 h. Recovery period was uneventful, without complications or postoperative nausea and vomiting