Inclusion Criteria:

- Patient has a physical status between ASA I and III

- Female

- 18 - 70 years of age

- Patients able to read a newspaper in Chinese.

- Elective unilateral wide excision/simple mastectomy and SLNB/ALND

- Patient has signed an informed consent

- Without contraindication of GA or PVB

- Body mass index (BMI) less than 24 kg/m2

Exclusion Criteria:

- ASA ＞ III

- inability to provide informed consent

- Bleeding disorders

- Contraindications to nonsteroidal anti-inflammatory drugs (NSAIDs)

- Allergy to amide-type local anesthetics or NSAIDs

- Infection at the thoracic paravertebral injection site

- Pregnancy or breast-feeding

- Severe spine or chest wall deformity

- body mass index equal to or more than 24 kg/m2

- patients with major psychosis or drug and alcohol abuse

- patients with a history of significant neurological, psychiatric, neuromuscular,
cardiovascular, pulmonary, renal or hepatic disease

- Patients with significant visual impairment or other physical disability that
precludes complete cooperation