Jadon Ashok, Agarwal Prashant S
Sr. Consultant & HOD Anaesthesia.
Indian J Anaesth. 2009 Dec;53(6):696-9.
A 47-yrs-female patient presented with carcinoma right breast, swelling and allodynia of right upper limb. radical mastectomy with axillary clearance and skin grafting was done under cervical epidural anaesthesia through 18G epidural catheter placed at C6/C7 level. Postoperative analgesia and rehabilitation of affected right upper limb was managed by continuous epidural infusion of 0.125% bupivacaine and 2.5 microg/ml(-1)clonidine solution through epidural catheter for 5 days and physiotherapy. This case report highlights the usefulness of cervical epidural analgesia in managing a complex situation of carcinoma breast with associated periarthitis of shoulder joint and chronic regional pain syndrome (CRPS) of right upper limb.
一名47岁女性患者，因右乳腺癌伴右上肢肿胀及痛觉过敏就诊。在C6/C7水平置入18G硬膜外导管，于颈段硬膜外麻醉下行根治性乳房切除术、腋窝清扫术及植皮术。术后通过硬膜外导管持续输注0.125%布比卡因和2.5微克/毫升可乐定溶液进行镇痛，并对患侧右上肢进行康复治疗，持续5天，同时进行物理治疗。本病例报告强调了颈段硬膜外镇痛在处理伴有肩关节周围炎和右上肢慢性区域疼痛综合征（CRPS）的复杂乳腺癌情况中的实用性。
