Minimal Pain Tumescent Local Anesthesia Injection for Wide Awake Modified Radical Mastectomy.
Sameer M PandyaTabitha NjugunaCarol MainaPankaj JaniDonald H LalondePublished in: Plastic surgery (Oakville, Ont.) (2022)
The advent of minimal pain tumescent local anesthesia injection has improved patient safety by eliminating the need for sedation for many wide awake operations, especially in patients with significant medical comorbidities. Modified radical mastectomy (MRM) for breast cancer is commonly performed under general anesthesia as it requires the dissection of the entire breast and an ipsilateral axillary lymph node dissection (ALND). General anesthesia has been shown to have a high risk in patients with severe medical comorbidities. We present a case of a 78-year-old male patient who was diagnosed with invasive ductal breast carcinoma, cardiac failure, and other metabolic abnormalities. Taking his comorbidities into account, we performed a wide awake MRM and ALND after tumescent minimal pain local anesthesia injection. The patient experienced the successful procedure safely with minimal discomfort.
Keyphrases
- patient safety
- chronic pain
- pain management
- ultrasound guided
- neuropathic pain
- lymph node
- healthcare
- deep brain stimulation
- case report
- quality improvement
- sentinel lymph node
- heart failure
- neoadjuvant chemotherapy
- rectal cancer
- squamous cell carcinoma
- radical prostatectomy
- spinal cord injury
- minimally invasive
- spinal cord
- radiation therapy
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation