Zemedkun Abebayehu, Destaw Belete, Milkias Mesay
Department of Anesthesiology, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
Local Reg Anesth. 2021 Jan 14;14:1-5. doi: 10.2147/LRA.S291308. eCollection 2021.
Mastectomy is mostly performed as definitive management for resectable breast cancer. Implementing paravertebral nerve block for patients with metastasis features of cancer to lungs and other organs, patients with co-morbidity, geriatrics, and malnourished individuals will eliminate the risks and complications of general anesthesia. Though thoracic paravertebral block is an established technique as postoperative pain management for breast surgery, there is no conclusive evidence on its use as a sole anesthetic for modified radical mastectomy. In this case report, we present a 33-year-old woman who underwent a successful modified radical mastectomy for stage IIIb breast cancer associated with clinical and radiological features of metastasis to the lung under a multiple injection landmark technique paravertebral nerve block. We believe that the anatomic landmark technique paravertebral nerve block can be used as an alternative anesthetic technique for modified radical mastectomy in a resource-limited setting for patients who are expected to have a high risk of perioperative complications under general anesthesia.
乳房切除术大多作为可切除乳腺癌的确定性治疗方法。对于具有癌症转移至肺部及其他器官特征、患有合并症、老年患者和营养不良个体的患者实施椎旁神经阻滞，可消除全身麻醉的风险和并发症。尽管胸段椎旁阻滞作为乳房手术术后疼痛管理的一种成熟技术，但尚无确凿证据表明其可作为改良根治性乳房切除术的唯一麻醉方法。在本病例报告中，我们介绍了一名33岁女性，她在多次注射体表标志技术椎旁神经阻滞下，成功接受了改良根治性乳房切除术，治疗IIIb期乳腺癌，该癌症伴有肺部转移的临床和影像学特征。我们认为，在资源有限的情况下，对于预计在全身麻醉下围手术期并发症风险较高的患者，体表标志技术椎旁神经阻滞可作为改良根治性乳房切除术的替代麻醉技术。
