Abstract
Background: Breast cancer mostly affects patients older than 65 years old. Geriatric patients may have comorbidities so the selection of anaesthesia for breast cancer surgery is challenging. In the past decade, thoracic spinal anaesthesia as regional anaesthesia was feasibly performed for laparoscopic cholecystectomy and minor breast surgery. This article aims to evaluate thoracal spinal anaesthesia for Modified Radical Mastectomy (MRM) in our hospital settings. Case: Three cases of Thoracal Spinal Anaesthesia were carried out for MRM surgery after neoadjuvant chemotherapy treatment. This procedure consists of removal of breast tissue and the ipsilateral axillary contents. The comorbidities include hypertension, cardiomegaly, and mild anaemia. There was no conversion to general anaesthesia during surgery until completion. Duration for surgery less than 120 minutes. No significant hemodynamic instability and complaint were found during intra and postoperative. Conclusion: From these cases, thoracal spinal anaesthesia was acceptable as regional anaesthesia for MRM in geriatric patient.
Highlights
Breast cancer is the highest incidence of malignancy in Indonesia
Regional anesthesia is a preferable option for breast cancer surgery in the geriatric group
While performing segmental spinal anesthesia, there were three main concerns includes the risk for spinal cord injury; cephalad spread of local anesthesia causing high or total block; and hemodynamic or respiratory compromise due to block of cardio accelerator fibers or intercostal nerves.[2]
Summary
Breast cancer mostly affects patients older than 65 years old. Geriatric patients may have comorbidities, so the selection of anesthesia for breast cancer surgery is challenging. Thoracic spinal anesthesia as regional anesthesia was feasibly performed for laparoscopic cholecystectomy and minor breast surgery. This article aims to evaluate thoracic spinal anesthesia for Modified radical mastectomy (MRM) in our hospital settings. Case: Three cases of thoracic spinal anaesthesia were carried out for MRM surgery after neoadjuvant chemotherapy treatment. This procedure consists of the removal of breast tissue and the ipsilateral axillary contents. Conclusion: From these cases, thoracic spinal anesthesia was acceptable as regional anesthesia for MRM in geriatric patients. Thoracic Spinal Anaesthesia for Modified Radical Mastectomy (MRM).
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