Impact of Pectoral Versus Paravertebral Blocks on Pain and Physical Well-Being in Implant-Based Breast Reconstruction

Exclusion Criteria

• •Delayed breast reconstruction
• •Allergy or contraindication to local anesthetics (PVB or PECS blocks)
• •History of radiation therapy
• •Planned sedation or general anesthesia protocol variation
• •Morbid obesity as defined as a BMI greater than 40 kg/m2
• •Renal insufficiency
• •Chronic pain syndrome or central sensitization disorders (e.g., fibromyalgia, CRPS)
• •Use of implanted pain devices or neuromodulators
• •Pre-existing neurological deficits in the surgical field
• •Current chronic opioid use (daily use within the 2 weeks before surgery and duration of use greater than 4 weeks)
• •Use of any nerve medications in the past 6 months, including antiepileptic medications (gabapentin, carbamazepine)
• •History of drug or alcohol abuse or habitual alcohol intake greater than two standard drinks per day (e.g., two beers, two glasses of wine, or two mixed drinks)
• •Any comorbidity that results in moderate or severe functional limitation, inability to communicate with the investigators or hospital staff
• •History of a psychiatric disorder which would interfere with the study procedure
• •Incarceration
• •Any issue that at the discretion of the investigator would contraindicate the subject's participation
• •Inability to understand the procedures and objectives of the study
• •Inability to or unwilling to provide informed consent