Chirurgie carcinologique du sein : anesthésie générale ou locorégionale ?

Breast cancer surgery is a very common surgical procedure. Chronic pain after breast surgery is frequent. Several clinical trials have pointed out the use of ketamine, α2δ calcium channel ligands and of local anaesthetic agents to prevent chronic pain after surgery, but results need to be confirmed. Thoracic paravertebral block provides excellent analgesia and allows to perform surgery without the need of general anaesthetics. Retrospective studies have suggested that paravertebral block may improve patient survival and decrease the incidence of metastasis, but they also need to be confirmed.