Anesthesia for Breast Surgery
For breast sentinel node or axillary node
surgery, your surgeon will often request a
nerve block for anesthesia. When patients
receive a nerve block for anesthesia they
often receive sedation during the surgery.
But, they may also receive general
anesthesia. The decision whether to have
sedation or general anesthesia is based on
the type of surgery and on your medical
The type of nerve block offered for breast
and lymph node surgery is called a thoracic
paravertebral nerve block.
What is a nerve block?
A nerve block means that numbing medicine
is placed near nerves that provide feeling to
a certain part of the body. For example, the
dentist does a nerve block to numb your
mouth for dental work.
What is a thoracic paravertebral
A thoracic paravertebral block involves
injecting numbing medicine in the space off
to the side of your spine. The nerves that
provide feeling to your chest wall, breast,
and axilla (arm pit) are located along your
back, just below your neck. We most often
place 2 or 3 injections to get all the nerves
that provide feeling to your chest wall.
What are the benefits of a nerve
By placing nerve blocks we reduce the need
for narcotic pain medicine during your
surgery. This reduces the amount of time it
takes you to wake up. It decreases your risk
for nausea and vomiting. A breathing tube
and general anesthesia are often not needed.
This decreases possible breathing problems.
Research also shows that using nerve blocks
for surgery will speed your recovery time by
a number of hours. As a rule, you will not
need pain medicine for up to 12 hours after a
nerve block because the surgery site remains
What are the risks of a nerve
There is always risk to any medicine or
procedure. In the case of thoracic
paravertebral nerve blocks the specific risks
are the ones listed below.
ξ Bleeding caused by the needle
ξ Infection started by the needle
ξ Nerve damage caused by the
ξ Damage caused to your lung
ξ Numbing effect spreads to the
other side of your body (epidural
ξ For a time, you may have a
droopy eyelid or weak arm
We take many steps to keep these blocks as
safe as possible. These steps include the use
of ultrasound for placement of the injections
when possible. In most cases, the benefits
outweigh the risks. We will discuss this
with you on the day of surgery. These
blocks have been done very successfully at
this hospital for many patients who are
having breast and lymph node surgery.
The day of surgery
1. You will arrive in pre-surgery area.
You will change into a gown. A
nurse will review your health history
and surgery plan. Some patients will
go to nuclear medicine or the breast
center for other procedures.
2. When you return, you will see an
anesthesiologist. He or she will talk
to you about your health and
anesthesia choices for the day. If
you choose to have a nerve block,
you will meet the block nurse. The
nurse will talk to you about your
health. The nurse will take you back
to a special room where the nerve
blocks will be placed.
3. If you choose to have a nerve block,
you will be made sleepy with
intravenous medicine. An
ultrasound machine will be used to
help guide the injections in your
back. Your skin will be numbed at
each injection site. When the nerve
block is complete, you will go to the
operating room. We will confirm
your name, birth date, and
procedure. You will receive
medicines that will allow you to
sleep during the surgery. Once the
operation is over, you will wake up.
You will return to your room. You
will be able to go home once you
have met certain standards.
4. If you choose to have general
anesthesia you will go to the
operating room from your pre-op
room. We will confirm your name,
birth date, and procedure. You will
have intravenous medicine to make
you fall asleep. You will have a
breathing tube placed. You will
remain unconscious during the
surgery. At the end of your surgery,
we will wake you up. The breathing
tube will be removed. You will go
to the recovery room. Here you will
continue to wake up. You will
receive any treatment you need for
pain or nausea. After this recovery
time, you will return to your room.
You will be able to go home or to
your hospital room once you have
met certain standards.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright ©10/17. University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7154