PVB is a common procedure used for analgesia in breast surgery in combination with multimodal perioperative pain regimens, though its use has not been formally studied in a prospective fashion. Our Division recently retrospectively studied the use of PVB in breast reduction, finding that postoperative pain scores and rates of PONV were decreased with the use of PVB. To date, no prospective, randomized, blinded study has been performed to evaluate the efficacy of PVB on perioperative pain management in this patient population. Multiple studies performed in patients undergoing post-mastectomy breast reconstruction have demonstrated the safety and efficacy of PVB as an adjunctive pain control modality. In a prospective study evaluating patients undergoing post-mastectomy autologous breast reconstruction, Parikh and colleagues found that patients who received PVB had significant improvement in postoperative pain, shorter time to oral-only opioid usage and decreased length of hospital stay compared to patients who received standard postoperative pain control [Parikh]. A meta-analysis conducted by Schnabel and colleagues studied 15 randomized controlled trials evaluating PVB in addition to general anesthesia for patients undergoing breast surgery found significant decrease in postoperative pain scores with low risk ratio for adverse events [Schnabel].