Experience of Regional Anesthesia in breast Surgeries: A Case Series

Abstract

Breast cancer surgeries, including Modified Radical Mastectomy (MRM), are commonly performed under general anesthesia. However, patients with multiple comorbidities, especially pulmonary issues and anticipated difficult airways, face increased perioperative risks. In this case series, we present successful perioperative management using regional anesthesia techniques in various breast surgeries, aiming to minimize pulmonary and systemic complications while providing effective anesthesia and postoperative analgesia.

Five cases are described, each illustrating the use of regional anesthesia modalities such as thoracic epidural anesthesia, Pectoral Nerve (PEC) I, and PEC II blocks. Patients with conditions like diabetes mellitus, bronchial asthma, hypertension, and difficult airways were managed safely and effectively under regional anesthesia, avoiding the risks associated with general anesthesia.

Discussion highlights the neuroanatomical considerations and specific regional anesthesia techniques employed in breast surgeries, including MRM and excision biopsies. Benefits of regional anesthesia include reduced perioperative analgesic consumption, superior postoperative analgesia, shorter recovery times, and improved hemodynamic stability.

By assessing the risk-benefit ratio, complications commonly associated with regional anesthesia, such as dural puncture or neurological injuries, can be mitigated with proper precautions and experience. Regional anesthesia emerges as a reasonable and safe alternative to general anesthesia for breast surgeries, offering optimal perioperative care and enhancing postoperative rehabilitation and pain management, ultimately promoting quicker recovery for patients.