@myoga just ask your doctor and mention that you want a paravertebral block in the pre-op appointment and any contacts with anesthesia.

I had two separate mastectomies. I had a paravertebral block with both. The first time, I made it clear I did not want pain meds but I woke with a dilaudid drip and vomited all night. The second time I made it REALLY clear to every person I spoke with that I did not want pain meds. I felt totally normal and pain free the second time.

I did have pain following those first days. I used codeine/tylenol combo sparingly (1/2 pill in late afternoon) for a couple of weeks. The second time had much less pain so apparently this varies!