Abstract

CASE REPORT OF MODIFIED RADICAL MASTECTOMY SURGERY UNDER THORACIC EPIDURAL ANAESTHESIA PLUS INTERSCALENE BLOCK

*Dr. Prashant Shahadeo Dhakne, Dr. Rajesh D. Subhedar and Dr. Rupali Patil

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Abstract

Surgery is one of the mainstays of treatment in breast cancers. Typically, modified radical mastectomy (MRM) is done under general anaesthesia (GA). However, GA is not a reasonable choice in patients with multiple comorbidities and difficult airways. Thoracic epidural anaesthesia (TEA) is a reasonable and safe alternative to GA as it involves blunting of stress response and avoidance of airway handling apart from hemodynamic stability, lower analgesic consumption, superior postoperative analgesia, reduced postoperative nausea and vomiting, earlier resumption of feeding, and shorter duration of hospitalization. We report a case of advanced breast cancer in a 72 -year-old female with a co-existing difficult airway, poor effort tolerance, COPD changes in whom MRM was conducted successfully under TEA plus right sided interscalene block. We also present a comprehensive review of literature on the use of TEA for MRM.

Keywords: MRM, GA, TEA.