Paravertebral Nerve Block and Propofol

I just spoke with my anesthesiologist for surgery tomorrow and was told that he and my surgeon are developing an Enhanced Recovery Pathway similar to the one in Wu et al. (for colorectal surgery) that could be used for breast surgery patients. He was very pleased when I asked him to follow this protocol for me this includes clear liquids up to 2 hours prior to surgery, the use of PVB and propofol, gabapentin and acetaminophen before surgery, antiemetics and a scopolamine patch to prevent nausea, tramadol and acetaminophen after surgery instead of heavier opioids. I'm beyond pleased that things are working out and want to thank everyone who has posted here and on the other pain threads for telling me about this! I'll post after surgery and let you know how I'm making out.

Good Luck Gramma

I had surgery yesterday afternoon they did the sentinel node injection first. This was very easy so I was all anxious for nothing. The block was placed next and wasn't too bad. I had a dizzy spell when they were near the end and my blood pressure dropped some so they did not give me the full treatment. I was still pretty numb and I'm still numb now. I got the Tylenol/ganapentin/Celebrex dose before treatment as well. On advice from the anesthesiologist I also drank a bottle of Gatorade a few hours before surgery to help prevent nausea and insulin resistance. Not sure if they gave me a dose of kerolac during surgery. I slept through the first night with no pain. They did give Tramadol before I went to sleep last nightand 2 Tylenol this morning. I'm not sure yet if I received any morphine during surgery by will try to find out.

All in all I think this was a good experience. Thank you all for your post about propofol, PVBs, and opioid-sparing pathways! I took full advantage and feel great this morning.

First night at home last night and I slept great in the recliner! I took a Tramadol before bed, woke up at 5 and took Tylenol, but I was not in any pain. I think my pain level has been barely a 1 or 2 (out of 10) since surgery. Today I'm going to try taking a shower

Best wishes to everyone and thanks again for starting this thread! I think it made all the difference for me!

Now that the mastectomy is out of the way I'm starting to think about the exchange surgery. The anesthetic regimen I had for the mastectomy should help to lower the risk for recurrences, but what about subsequent surgeries? Is there also a risk with those? Or is the risk only associated with removal of the cancerous tissue?

We asked that when he was here that day and he said it is probably a good idea for reconstruction with regard to ketorolac. I wanted to know if we have to do it in every surgery we have for the rest of our lives. Doesn't it seem like the risk would never completely leave, if the theory that dormant cells are awakened is correct? I have run across women here who have recurred 20 years later. Something has to trigger it at that late date but we will probably never know what.

Bump