Combined thoracic erector spinae plane and inter-transverse plane blocks for awake breast surgery.
Francesco MarroneP F FuscoS PaventiM TomeiS FailliF FabbriC PullanoPublished in: Anaesthesia reports (2024)
Worldwide, breast cancer is the most commonly diagnosed cancer in women. Surgical procedures are typically performed using general anaesthesia, often complemented by regional anaesthesia to manage postoperative pain. However, avoidance of general anaesthesia for breast surgery may be desirable for clinical reasons or patient choice. It is theorised that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes, and there is some evidence to support this. While many patients successfully undergo awake breast surgery, a limited number of anaesthetists possess direct experience of this approach, despite familiarity with regional anaesthesia techniques. Undertaking regional anaesthesia for awake breast surgery requires patient cooperation and excellent staff teamwork. Here, we present a case of a patient who underwent awake bilateral mastectomy with reconstruction. This was carried out under two 'paravertebral-by-proxy' blocks: the thoracic erector spinae plane and inter-transverse plane blocks, with intravenous sedation.
Keyphrases
- pain management
- ultrasound guided
- minimally invasive
- coronary artery bypass
- postoperative pain
- case report
- surgical site infection
- deep brain stimulation
- spinal cord
- ejection fraction
- end stage renal disease
- chronic pain
- prostate cancer
- newly diagnosed
- squamous cell carcinoma
- coronary artery disease
- high dose
- percutaneous coronary intervention
- atrial fibrillation
- prognostic factors
- adipose tissue
- insulin resistance
- skeletal muscle
- intensive care unit
- radical prostatectomy
- weight loss
- breast cancer risk