Combined thoracic epidural anaesthesia and interscalene brachial plexus block for modified radical mastectomy in a high-risk patient

Deepak S. Phalgune, Shripad Mahadik, Sushmitha K
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Abstract

In a case of malignancy of the breast, operation is one of best option for the management of the patient. Modified radical mastectomy (MMR) is commonly conducted by giving general anaesthesia (GA). But GA is not a rational choice in patients who are suffering from bronchial asthma and other associated comorbidities. These patients have additional danger of perioperative morbidity and mortality especially because of respiratory complications. We report successful perioperative management of MMR under combined thoracic epidural anaesthesia and ipsilateral interscalene brachial plexus block in a diagnosed case of malignancy of breast with bronchial asthma, type 2 diabetes mellitus and hypertension.
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胸硬膜外麻醉和臂丛神经阻滞联合应用于一名高危患者的改良根治性乳腺切除术
在乳腺恶性肿瘤的情况下,手术是治疗病人的最佳选择之一。改良根治性乳房切除术(MMR)通常采用全身麻醉(GA)。但对于患有支气管哮喘和其他相关合并症的患者来说,全身麻醉并不是一个合理的选择。这些患者围手术期的发病率和死亡率会增加,尤其是呼吸系统并发症。我们报告了在联合胸硬膜外麻醉和同侧臂丛神经阻滞下,对一例确诊为乳腺恶性肿瘤并伴有支气管哮喘、2 型糖尿病和高血压的患者成功实施 MMR 的围手术期管理。
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