Background: General anaesthesia (GA) is the conventional technique used for surgical treatment of breast lumps. However, various side effects and complications of GA, such as postoperative pain, nausea, vomiting, and increased hospital stay increase morbidity in patients. Regional anaesthesia using multiple injection paravertebral block is an ideal alternative to GA for breast surgeries.Methods: Sixty female patients posted for unilateral breast surgery were randomly divided into two groups, Group P for paravertebral block and group G for GA, and compared on the basis of time taken for induction of anaesthesia, postoperative pain relief on basis of Visual Analogue Scale (VAS) score, postoperative nausea and vomiting (PONV) and duration of hospital stay.Results: Duration of surgery in group P was 64.75±18.07 and 67.32±17.64 in group G respectively (P>0.05). Time for inducing anaesthesia was significantly longer in group P (17.15±3.92min) compared to group G (5.90±1.75min) with P<0.05. Significant difference (P<0.001) was observed in the mean duration of postoperative analgesia of group P (298.34±67.02min) and group G (107.68±27.28min). The VAS scores in immediate postoperative period and after two and four hours in the postoperative period were significantly higher in group G (P<0.05). The incidence of postoperative nausea and vomiting was significantly higher in group G (13 out of 30 patients) than group P (four out of 28 patients) with P<0.05. Conclusion:The efficacy and safety of paravertebral block for operative treatment of breast tumors, excellent analgesia in early postoperative period, requirement of significantly lesser amount of postoperative analgesics, decreased incidence of PONV and negligible complications along with early ambulation and hospital discharge makes it an afferent cost-effective block of choice for unilateral breast surgeries.

Rationale: In Indian subcontinent, every adult may have suffered from chicken pox during their early childhood and harbour the virus, which eventually becomes inactive over years. These latent organisms can undergo sudden activation when triggered by injection of local anaesthesia in the oral cavity. Probably, some symptoms develop along the distribution of the nerve. Patient Concerns: Here, we present a case report of a 55-year-old male patient who reported to us with post-anaesthetic herpetic lesion involving the face unilaterally and also a lesion present in the intraoral cavity not crossing the midline. Diagnosis: The patient was diagnosed as post-anaesthetic herpetic lesion. Treatment: Symptomatic medical management was given. Outcomes: On two month follow-up, the lesion was completely resolved and replaced by healthy tissue. Take-Away Lesson: Medical history should also include a question about past experience with chicken pox before proceeding with extraction.