Abstract
BackgroundAnesthetic considerations for surgery during pregnancy include the safety of both mother and fetus. We successfully administered anesthesia for total mastectomy to a pregnant woman using general anesthesia combined with continuous erector spinae plane block.Case presentationA 41-year-old woman was scheduled to undergo total mastectomy at 18 weeks’ gestation. Hence, we decided to administer general anesthesia combined with continuous erector spinae plane block to minimize physiological stress on both mother and fetus. Continuous erector spinae plane block provided sufficient postoperative analgesia for our patient, completely eliminating the need for additional rescue analgesia during the entire postoperative period.ConclusionsGeneral anesthesia combined with continuous erector spinae plane block provided adequate analgesia without maternal hypotension in a pregnant woman undergoing total mastectomy.
Highlights
Anesthetic considerations for surgery during pregnancy include the safety of both mother and fetus
Thoracic epidural anesthesia is associated with the potential risks of accidental dural puncture, subarachnoid injection, and maternal hypotension, which would adversely affect uteroplacental blood flow [6]
It was previously reported that erector spinae plane (ESP) block provides complete surgical anesthesia for radical mastectomy [7]
Summary
Anesthetic considerations for surgery during pregnancy include the safety of both mother and fetus. The use of regional block techniques that have minimal effects on maternal hemodynamics might be a safer option during surgery in pregnant women. We report a case of successful anesthetic management for total mastectomy in a pregnant woman using general anesthesia combined with continuous ESP block. To the best of our knowledge, this is the first report discussing the efficacy of continuous ESP block for mastectomy in a pregnant woman.
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