Pandya Sameer M, Njuguna Tabitha, Maina Carol, Jani Pankaj, Lalonde Donald
Nakuru County, Referral & Teaching Hospital, Nakuru, Kenya.
University of Nairobi, Nairobi, Kenya.
Plast Surg (Oakv). 2024 May;32(2):357-359. doi: 10.1177/22925503221120573. Epub 2022 Sep 15.
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.
微痛肿胀局麻注射法的出现,通过消除许多清醒手术(尤其是患有严重内科合并症的患者)对镇静的需求,提高了患者的安全性。乳腺癌改良根治术(MRM)通常在全身麻醉下进行,因为它需要切除整个乳房并进行同侧腋窝淋巴结清扫术(ALND)。全身麻醉已被证明在患有严重内科合并症的患者中具有高风险。我们报告一例78岁男性患者,他被诊断患有浸润性导管癌、心力衰竭和其他代谢异常。考虑到他的合并症,我们在肿胀微痛局麻注射后为他进行了清醒状态下的MRM和ALND。患者安全地完成了手术,不适感极小。