2-Step Surgical Field Block Comparable to Paravertebral Bloc
Anesthesiologists searching for a simple alternative to the paravertebral block in breast surgery patients might consider a technique adopted by researchers at the University of Ottawa, in Ontario. Their two-step surgical field block proved comparable to the paravertebral block in all measured outcomes in the early postoperative period and in the setting of chronic postsurgical pain.

“There’s quite a bit of literature suggesting that paravertebral blocks are superior to traditional opioid analgesic techniques in breast cancer surgery patients,” said Shachar Ben-Zeev MD, a fellow in regional anesthesia at the University of Ottawa. “But we noticed that a lot of the literature that supports this notion is really limited, most importantly by the fact that there’s no active comparator. And we thought we’d look at the impact of paravertebral blocks compared with what we call a two-step surgical field block, which is essentially wound infiltration with local anesthetic by the surgeons combined with instillation of local anesthetic into the surgical drain.”...