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This study compared an ERAS approach combining nonintubated general anesthesia with thoracic paravertebral block (TPVB) against conventional general anesthesia in unilateral mastectomy patients. Sixty female patients were reviewed; postoperative pain (NRS), analgesic consumption, and postoperative nausea and vomiting (PONV) were analyzed to assess efficacy and safety.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/multimodal-analgesia-with-thoracic-paravertebral-block-decrease-pain-and-side-effects-in-mastectomy-patients/436022/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/multimodal-analgesia-with-thoracic-paravertebral-block-decrease-pain-and-side-effects-in-mastectomy-patients/436022.png","ImageObject",300,407,{"name":92,"@type":93},"Ivy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What pain outcomes were compared between the MMA-TPVB group and conventional GA?","Question",{"text":112,"@type":113},"Postoperative pain scores were assessed with numerical rating scale (NRS). The MMA group showed significantly lower NRS scores than the GA group.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was opioid and analgesic consumption standardized for comparison?",{"text":117,"@type":113},"Postoperative analgesics, including pethidine and tramadol, were converted into intravenous morphine equivalents before group comparisons.",{"name":119,"@type":110,"acceptedAnswer":120},"Did thoracic paravertebral block-based MMA change postoperative nausea and vomiting (PONV) rates?",{"text":121,"@type":113},"PONV rates were lower in the MMA group than in the GA group, but the difference was not statistically significant, with PONV managed effectively in both groups.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436022,1790717095,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","J Chin MedAssoc  \nOriginal article  \nMultimodal analgesia with thoracic paravertebral block decrease pain and side effects in mastectomy patients  \nPei-Chin Liua,b, Fu-Wei Sub,c, Yi-Fang Tsaid,e, Yen-Shu Lind,e, Chun-Sung Sungb,d, Ling-Ming Tsengd,e, Wei-Nung Tengb,d,*  \naDepartment of Anesthesiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC; bDepartment of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cDepartment of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; eDivision of Breast Surgery, & Comprehensive Breast Health Center, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC  \nAbstract  \nBackground: Enhanced recovery after surgery (ERAS) protocols incorporating multimodal analgesia (MMA) have become increasingly popular for breast cancer surgery. Our study evaluated an ERAS approach that combined nonintubated general anesthesia (GA) with thoracic paravertebral block (TPVB) as part of the MMA and compared it with traditional GA. Postoperative outcomes were assessed using numerical rating scale (NRS) pain scores, total analgesic consumption, and postoperative nausea and vomiting (PONV) .  \nMethods: We reviewed the medical records of 60 female patients aged 30 to 85 years who underwent unilateral mastectomy with or without sentinel lymph node biopsy (SLNB) . Thirty patients received nonintubated GA with a regional block (MMA group), whereas the remaining 30 patients received conventional GA and were matched based on their anesthesia records. Postoperative analgesics, including pethidine and tramadol, were converted into intravenous morphine equivalents. We compared the groups using paired t tests for age, height, weight, operation duration, NRS scores, total analgesic dosage, and the Fisher exact test for PONV rates.  \nResults: The MMA group showed significantly lower NRS scores (p \u003C 0.001) and total analgesic consumption (p \u003C 0.001) than the GA group. Although PONV rates were lower in the MMA group (0% vs 13%, p = 0. 112), this difference was not statistically significant, likely due to the effective PONV management in the GA group with dexamethasone or 5-Hydroxytryptamine type 3 (5HT-3) antagonist. There was no significant difference in pain scores (p = 0.722) or the need for additional analgesics (p = 0.419) between double-and triple-level TPVB.  \nConclusion: Nonintubated GA with total intravenous anesthesia (TIVA) and MMA using TPVB is a viable and safe alternative for breast cancer surgery. It results in reduced pain scores and analgesic needs compared with conventional GA, with PONV outcomes comparable to those managed with standard intravenous medications.  \nKeywords: Enhanced recovery after surgery; Intravenous anesthesia; Mastectomy; Paravertebral block; Postoperative complication  \nLay Summary: This study evaluated the effectiveness and safety of nonintubated general anesthesia with total intravenous anesthesia (TIVA) combined with multimodal analgesia (MMA) using thoracic paravertebral block (TPVB) in patients undergoing mastectomy. 30 patients receiving MMA were compared to 30 patients  \n*Address correspondence. Dr. Wei-Nung Teng, Department of Anesthesiology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: weinungteng@gmail.com](ROC. E-mail address: weinungteng@gmail.com) (W.-N. Teng).  \nConflicts of interest: Ling-Ming Tseng, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2025) 88: 486-491.  \nReceived August 14, 2024; accepted November 12, 2024. doi: 10. 1097/JCMA.0","cbCait8P6yH5hsia","https://ap.wps.com/l/cbCait8P6yH5hsia","pdf",569956,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What pain outcomes were compared between the MMA-TPVB group and conventional GA?\",\"answer\":\"Postoperative pain scores were assessed with numerical rating scale (NRS). The MMA group showed significantly lower NRS scores than the GA group.\"},{\"question\":\"How was opioid and analgesic consumption standardized for comparison?\",\"answer\":\"Postoperative analgesics, including pethidine and tramadol, were converted into intravenous morphine equivalents before group comparisons.\"},{\"question\":\"Did thoracic paravertebral block-based MMA change postoperative nausea and vomiting (PONV) rates?\",\"answer\":\"PONV rates were lower in the MMA group than in the GA group, but the difference was not statistically significant, with PONV managed effectively in both groups.\"}]","Multimodal analgesia with thoracic paravertebral block decrease pain and side effects in mastectomy patients | PDF",1790676444,15]