Anesthesia for Mastectomy with Autologous Flap

Abstract

Mastectomy is performed for treatment of breast cancer or for prophylaxis of high-risk patients. The procedure is usually done under general anesthesia with or without regional analgesia. Reconstructive flap surgery is done to improve the quality of life. Autologous flaps provide better cosmetic and better longer term results than synthetic grafts. Common autologous flaps are transversus abdominis myocutaneous, deep inferior perforator epigastric perforator, and latissimus dorsi flap. Anesthesia plays an important role in the success of surgery. The procedure is long and needs meticulous attention to hemodynamics and maintenance of the flap perfusion which can be challenging. Chronic pain is common after mastectomy procedures; regional anesthesia together with other pharmacological analgesic therapy helps to reduce the development of chronic pain.