Objective      To determine the effect of ultrasound-g

uided thoracic paravertebral blocking combined with total intravenous anesthesia (TIVA) on the postoperative pain in patients after modified radical mastectomy.       Methods      Sixty female patients (18 to 85 years old) with America Society of Anesthesiologist (ASA) score of Ⅰ～Ⅲ undergoing modified radical mastectomy in our hospital from March to December 2014 were prospectively recruited in this study. They were equally randomized into intravenous-inhalation general anesthesia group and thoracic paravertebral block plus TIVA group. Patient-controlled intravenous analgesia (PCIA) was applied in the both groups. The heart rate (HR)

blood pressure

oxyhemoglobin saturation (SpO

2

)

end-tidal carbon dioxide (P

ET

CO

2

) and bispectral index (BIS) were recorded before medication (T

1

)

immediately before surgery (T

2

)

5 min after skin incision (T

3

)

at axillary dissection (T

4

)

end of mastectomy (T

5

)

remove of laryngeal mask (T

6

)

and out of post anesthesia care unit (PACU

T

7

). Visual analogue pain (VAS) scoring was used to evaluate the pain score in  2

4

8

16 and 24 h after operation. The consumption of sufentanil during operation

PACU stay time

PCIA sufentanil consumption

frequency of PCIA and incidences of complications related to anesthesia and analgesia were also recorded and compared between the 2 groups.       Results      Only at the beginning and ending of surgery

HR was significantly higher in the thoracic paravertebral block group than intravenous-inhalation general anesthesia group

but at the end of operation

HR was obviously lower in the former than the latter group (P0.05). There were no significant differences in BP

SpO

2

P

ET

CO

2

and BIS between the 2 groups during operation (P0.05). The former group had significantly lower VAS pain scores at resting and during coughing when compared with those of the latter group at 2

4 and 8 h after operation (P0.05)

. The former group also had smaller consumptions of sufentanil during operation and PCIA

shorter PACU stay time

lower frequency of PCIA pressing than the latter group (P0.05). The incidences of complications were less in the former than the latter groups

but no significant difference was seen in the incidence (P0.05).       Conclusion      The thoracic paravertebral block combined TIVA is safe and effective in modified radical mastectomy with less opioid consumption

shorter PACU stay time and more satisfactory results in postoperative pain control.