THORACIC EPIDURAL ANAESTHESIA FOR MODIFIED RADICAL MASTECTOMY IN CARCINOMA BREAST CASES- A RETROSPECTIVE DESCRIPTIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 2
Abstract
BACKGROUND Routinely breast surgeries including Modified Radical Mastectomy have been performed under general anaesthesia. In spite of the availability of many regional anaesthesia techniques for breast surgeries, achievement of complete anaesthesia for extensive oncologic procedures is difficult with the use of field blocks and local infiltrative techniques. Epidural anaesthesia has been associated with fewer postoperative complications and earlier hospital discharge for such cases including Modified Radical Mastectomy with axillary clearance. MATERIALS AND METHODS This is a Retrospective Descriptive Study. Informed consent was obtained. With the patient in the lateral decubitus position, under strict aseptic precautions, 18-G Tuohy’s needle was inserted at the level of T4 - T5 and the catheter tip was placed at T1 epidural space. A test dose of 2 mL 2% Lignocaine with adrenaline 1:200000 was given and then 10 - 13 mL of 0.5% Bupivacaine with 30 mcg Inj. Clonidine was given. Level of sensory blockade, need for sedation, intraoperative haemodynamic parameters and postoperative pain scores were noted. RESULTS 50 patients belonging to the age group 55 - 70 years of age who underwent oncological breast surgeries including Modified radical mastectomy with axillary clearance under thoracic epidural anaesthesia were reviewed between the periods of Jan 2016 - Sep 2017. Adequate level of sensory blockade B/L was achieved with a Modified Ramsay sedation score of 2 in most patients. Postoperative pain scores were between 0 - 1 in all the patients. CONCLUSION Thoracic epidural anaesthesia can be safely used in geriatric women undergoing Modified Radical Mastectomy for breast carcinoma.
Authors and Affiliations
Shanmugam P. S, Nimi Gopal, Sowmya Shanmugam
Keywords
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- EP ID EP284525
- DOI 10.14260/jemds/2018/35
- Views 71
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