Combined transverse thoracis plane and pectoral nerve blocks for breast surgery under sedation. Issue 1 (2nd February 2021)

• Record Type: Journal Article
• Authors: Helmich, E. J.; Van Den Broek, R. J.; Bloemen, J. G.
• Is Part Of: Anaesthesia reports. Volume 9:Issue 1(2021)
• Page Start: 28
• Page End: 31
• Publication Date: 2021-02-02
• Subjects: breast surgery -- lumpectomy -- pectoral nerve block -- regional anaesthesia -- transverse thoracis plane block; Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1002/anr3.12097
• Languages: English
• ISSNs: 2637-3726

Abstract

Summary: The pectoral nerves 2 (pecs 2) block is widely used as adjunct to general anaesthesia for breast surgery. There are a few case reports and a single case series that describe regional anaesthesia as a single technique or supplemented by light to moderate sedation. Here we describe the management of a 91‐year‐old ASA physical status 4 patient who presented with a T4 breast malignancy. She was considered unfit for general anaesthesia due to significant valvular heart disease. A wide local excision was successfully performed under a pecs 2 block and a transverse thoracis plane block, supplemented with light sedation. We consider this technique to be a good option for selected patients who are considered unfit for general anaesthesia.