LAUSR

Dear Editor, Breast cancer is the most common malignant tumor in women and surgical management remains a key component of treatment and cure [1]. However, the surgical procedure is often associated with varying degrees of postoperative pain. Approximately 60% of women after breast cancer surgery complain of severe acute pain [2]. In addition, failure to manage acute postoperative pain may lead to the development of chronic pain which may be persistent for years [3, 4]. As chronic persistent pain arises in approximately 50% of patients after breast cancer surgery [5], it is therefore necessary to explore efficacious techniques that can reduce postoperative pain for such patients. The innervation of the skin and gland of the breasts is supplied mainly by the T2-T6 spinal nerves. In addition, branches of the brachial plexus, including the long thoracic nerve, thoracodorsal nerve, medial pectoral nerve, and lateral pectoral nerve, are also involved in conveying sensation to the breasts and axillary region [6]. Therefore, to provide complete postoperative analgesia for breast cancer surgery, it is necessary to theoretically block the ten spinal nerve dermatomes from vertebral C5 to T6. Various regional techniques have been widely used to decrease postoperative pain after breast cancer surgery, including epidural, paravertebral, and intercostal blocks. However, an optimal method has not yet been defined and each of these blocks has some drawbacks. The epidural block involves unnecessary contralateral block, epidural hematoma, abscess, and dural puncture. The paravertebral block can achieve a perfect analgesic effect but it may cause pneumothorax and is difficult to implement. The intercostal nerve block is easy to perform but needs to be implemented in multiple segments.