Paravertebral somatic nerve block (PVB) provides improved analgesia and decreased side effects compared with general anesthesia for breast surgery. The analgesia is limited with single injection PVB to the duration of the local anesthetic. Continuous paravertebral catheters and disposable home infusion systems allow extended analgesia after major breast surgery while maintaining the ambulatory status of the patient. We describe the successful use of continuous paravertebral anesthesia in two patients undergoing major breast surgery. A novel needle system for paravertebral catheter insertion is also presented.