Save
ANESTHETIC USE OF PECS II BLOCK ASSOCIATED WITH IORT (INTRA OPERATIVE RADIATION THERAPY): IS THIS THE FUTURE OF BREAST SURGERY?
Author(s): ,
Fusco, P.*
Affiliations:
San Salvatore Academic Hospital of L'Aquila, Department of Anesthesia and Intensive Care Unit, L'Aquila, Italy
,
Ruotolo, F.
Affiliations:
University of Campania "Luigi Vanvitelli", Anesthesia- Intensive Care and Pain Medicine Unit, Naples, Italy
,
De Divitiis, D.
Affiliations:
University of Campania "Luigi Vanvitelli", Anesthesia- Intensive Care and Pain Medicine Unit, Naples, Italy
,
Scimia , P.
Affiliations:
A.S.S.T. of Cremona, Department of Anesthesia and Perioperative Medicine, Cremona, Italy
,
De Sanctis , F.
Affiliations:
University of L'Aquila, Department of Life - Health and Enviromental Sciences, L'Aquila, Italy
Marinangeli, F.
Affiliations:
University of L'Aquila, Department of Life - Health and Enviromental Sciences, L'Aquila, Italy
ESRA Academy. fusco p. Sep 13, 2017; 190867
Topic: Trunk Blocks
Dr. pierfrancesco fusco
Dr. pierfrancesco fusco

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.

Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Breast quadrantectomy is usually associated with IORT to provide a better oncologic outcome, but this management can prolog the surgical time with negative effects especially in high anesthetic-risk patients. The new blocks of thoracic wall provide a good analgesia and a good anesthetic plane.

Methods:

 A 60-year-old woman, ASA III, undergoing lateral quadrantectomy, sentinel lymph node biopsy and IORT for an invasive breast cancer. She was affected by ischaemic heart disease, hypertension, severe anxious-depressive syndrome, allergy to NSAIDs. We performed an ultrasound-guided PECS II block by injecting 0.5% Ropivacaine 20 ml in the fascial plane between Pectoralis Minor and Serratus Anterior muscles at the level of 4th rib. An intraoperative sedation maintaining spontaneous breathing, with easy arousability, was ensured with TCI propofol (1,5-2,5 ng/ml) with 65-75 BIS-monitoring values. Supplemental oxygen (4 lt/min) was administered by nasal cannula and EtCO2 was monitored.

Results:

An appropriate anesthetic plane was achieved with PECS II Block only: the patient maintained a good hemodynamic stability and an excellent control of anxiety during the whole surgical procedure, which lasted 2 hours. She was monitored in the recovery room and reported a complete pain control without needing rescue analgesia. No opiates were required neither in PACU nor in the first 24 hours in the surgical ward.

Conclusions:

This experience highlights how PECS II could be a opioid sparing technique and a feasible alternative to general anesthesia. It provided both a complete anesthesia, even when surgical time was prolonged by IORT, and a good post-operative analgesia.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings