Abstract
Swyer-James-MacLeod Syndrome is a rare acquired pulmonary disorder that develops secondary to infectious etiologies in early childhood. Patients who are affected have the potential of developing perioperative respiratory complications. While regional anaesthetic techniques are often performed as adjuncts to general anaesthesia, there is less data on breast operations being done solely under regional anaesthesia. We herein describe a patient with Swyer-James-MacLeod Syndrome who underwent breast lesion wide excision under combined paravertebral and pectoral nerves block, supplemented with propofol infusion for sedation. Choice of blocks was decided upon based on knowledge on the anatomy. Sole regional anaesthetic techniques have been the safest approach in some circumstances and should always be considered in patients who are of high risk under general anaesthesia.
Highlights
Swyer-James-MacLeod Syndrome (SJMS) is a rare, acquired post-infectious condition characterised by emphysematous changes or bronchiectasis which may lead to fibrosis to cause pulmonary capillary bed destruction
Sole regional anaesthetic techniques have been the safest approach in some circumstances and should always be considered in patients who are of high risk under general anaesthesia
We describe a patient with SJMS who successfully underwent breast surgery under regional anaesthesia
Summary
Swyer-James-MacLeod Syndrome (SJMS) is a rare, acquired post-infectious condition characterised by emphysematous changes or bronchiectasis which may lead to fibrosis to cause pulmonary capillary bed destruction. Patients with severe lung disease presenting for anaesthesia are a challenge because intraoperative and postoperative respiratory complications are more common in them, and these may lead to prolonged hospital stay and increased mortality. Y. Thong anaesthetic techniques are often used adjunctively for breast surgeries under general anaesthesia (GA), but there are limited reports on breast surgeries done solely under regional anaesthesia (RA). We describe a patient with SJMS who successfully underwent breast surgery under regional anaesthesia
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