HF 7154

Anesthesia for Breast Surgery

For breast sentinel node or axillary node surgery, your surgeon will often request a nerve block. These patients often also have sedation or general anesthesia during the surgery. The type of anesthesia is based on the type of surgery and your health problems.

Nerve Block

A nerve block is numbing medicine placed near nerves that give feeling to a certain part of the body. For example, the dentist does a nerve block to numb your mouth for dental work.

Thoracic Paravertebral Nerve Block

The most common type of nerve block is a thoracic paravertebral nerve block. This is a nerve block that injects numbing medicine in the space off to the side of your spine. The nerves that provide feeling to your chest wall, breast, and arm pit are along your back, just below your neck. Most often 2 or 3 injections are used to numb all the nerves that give feeling to the chest wall.

Benefits of a Nerve Block

  • Reduces need for narcotic pain medicine

  • Speeds recovery time

  • Decreases the risk for nausea and vomiting

  • Decreases risk for breathing problems

Risks of a Nerve Block

  • Bleeding

  • Infection

  • Nerve damage

  • Damage caused to your lung

  • Numbing effect spreads to the other side of your body (epidural spread)

  • Short-term droopy eyelid or weak arm

We take many steps to keep these blocks safe. They include the use of ultrasound for placement of the nerve block. In most cases, the benefits outweigh the risks. We will discuss this with you on the day of surgery. These blocks have worked well for many breast and lymph node surgery patients.

Day of Surgery

Go to the pre-surgery area where 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. When you return, you will see an anesthesiologist. They will talk to you about your health and anesthesia choices.

Surgery with Nerve Block

  1. You will meet the block nurse who will talk to you about your health. They will take you back to a special room where the nerve blocks will be placed.

  2. You will get medicine through your IV that will make you sleepy.

  3. An ultrasound machine will be used to help guide the injections in your back.

  4. Your skin will be numbed at each injection site.

  5. When the nerve block is complete, you will go to the operating room.

  6. We will confirm your name, birthdate, and procedure.

  7. You will get medicine to make you sleep.

  8. When the surgery is over, you will wake up.

  9. You will return to your room.

  10. You can go home when the doctors discharge you.

Surgery with General Anesthesia

  1. You will go to the operating room.

  2. We will confirm your name, birth date, and procedure.

  3. You will get medicine to make you fall asleep.

  4. You will have a breathing tube placed.

  5. You will stay asleep for the surgery.

  6. After surgery, we will wake you up.

  7. The breathing tube will be removed.

  8. You will go to the recovery room where you will still be waking up.

  9. You will get what you need for pain or nausea.

  10. You will return to your room.

  11. You can go home when the doctors discharge you.