Open AccessA pecs block to enable mastectomy in an elderly patient
Author(s) -
MORIMOTO YASUHIRO,
TANAKA ERIKO,
SHIMAMOTO YOKO
Publication year - 2014
Publication title -
anaesthesia cases
Language(s) - English
Resource type - Journals
ISSN - 2396-8397
DOI - 10.21466/ac.apbtemi.2014
Subject(s) - medicine , ropivacaine , lidocaine , anesthesia , mastectomy , hemodynamics , dexmedetomidine , surgery , nerve block , breast surgery , infiltration (hvac) , breast cancer , cancer , physics , sedation , thermodynamics
Summary A 94‐year‐old female suffered from heart failure 1 month prior to surgery and was treated with oral therapies. A breast tumour with local skin invasion was confirmed, and surgery was recommended. Because of concerns that general anesthesia might interfere with her haemodynamics, she was scheduled for a total mastectomy under regional anaesthesia. We used 40 ml of 0.227% ropivacaine for the pectoral nerve (pecs) block under ultrasound guidance. Dexmedetomidine was administered intravenously before the block; the dose was 0.15‐0.65 μg.kg ‐1 .hr ‐1 during surgery. Local infiltration with 0.5% lidocaine was used to manage intraoperative pain. Her haemodynamic status was maintained during the block and surgery, and no opioids were required. At the end of the procedure, the patient was pain‐free. We conclude that the pecs block is useful in the anaesthetic management of high‐risk patients during breast surgery.