Thoracic epidural anesthesia and interscalene block for a pneumonectomized patient posted for modified radical mastectomy

Thoracic epidural anesthesia with ipsilateral brachial plexus block is emerging as an alternative to general anesthesia for oncologic breast surgery.1. A 31 year old, pneumonectomised female with a past history of MDR TB was diagnosed with infiltrating ductal carcinoma in left breast 2 months ago an...

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Bibliographic Details
Main Authors: Mridul Dua, Bhoomi Raval, Syeda Farha Nasreen, V R R. Chari
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Medical Journal of Dr. D.Y. Patil University
Subjects:
Online Access:http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2017;volume=10;issue=6;spage=605;epage=607;aulast=Dua
Description
Summary:Thoracic epidural anesthesia with ipsilateral brachial plexus block is emerging as an alternative to general anesthesia for oncologic breast surgery.1. A 31 year old, pneumonectomised female with a past history of MDR TB was diagnosed with infiltrating ductal carcinoma in left breast 2 months ago and was posted for MRM. She also had moderate Pulmonary Arterial Hypertension. Thoracic epidural anesthesia was induced with 12 ml of 0.5% Ropivacaine at T6-T7 level. Interscalene block was given with 10 ml 0.5% Ropivacaine using peripheral nerve locator. Patient was comfortable throughout the procedure and remained vitally stable. Post-operative analgesia was given with 10 ml of 0.2% ropivacaine and patient was discharged the following week. Thoracic epidural anesthesia provides the advantage of superior intra and post-operative analgesia without the adverse effects of general anesthesia like postoperative nausea, vomiting, respiratory depression and sedation.2 Coupled with interscalene block for axillary lymph node dissection, it can be successfully used as an alternative to GA for MRM.
ISSN:0975-2870
2278-7119