 Paravertebral block will be performed as usual, as described by Moller 17. Patients will be in a sitting position with a staff member standing in front of the patient to ensure safety. The surgical site will be marked both in the front and on the back of the patient with dual confirmation from the consent and the patient. Mild sedation will be given using midazolam 2 mg and fentanyl 100 μg. The superior aspects of the spinous processes of thoracic levels C7-T5 will be identified with palpation. The needle entry site will be marked at 2.5 cm lateral to each spinous process ipsilateral to the operative breast. Using a 22-gauge, Tuohy needle B Braun Medical Inc, Bethlehem, PA, USA attached via extension tubing to a syringe, the needle will be advanced anteriorly in the parasagittal plane perpendicular to the back in all directions until it contacts the transverse process. The needle will then be withdrawn to the subcutaneous tissue and angled to walk off the caudal edge of the transverse process. From the caudal edge, it will then be advanced anteriorly approximately 1 cm. 17 After negative aspiration of the syringe, 4 mL of 0.5 ropivacaine will be injected at each of the six levels. These injections correspond to the T1-T6 spinal root levels. 