Combined Thoracic Paravertebral Block-Interscalene Block as a Primary Anesthetic for Modified Radical Mastectomy: A Case Report.

BACKGROUND

Regional anesthesia as a primary anesthetic can offer merits over general anesthesia for patients having multiple comorbidities who are at a high risk of perioperative morbidity and mortality. Thoracic paravertebral block (TPVB) and interscalene block (ISB) have been used widely to improve the quality of postoperative analgesia after breast surgery.

OBJECTIVE

There are limited data on the feasibility of combining TPVB-ISB as a sole anesthetic technique for extensive breast surgery with axillary lymph nodes dissection.

CASE PRESENTATION: In this report, the author presented a successful use of a combined TPVB and ISB as a sole anesthetic with conscious sedation in a 52-year-old patient with multiple comorbidities, including heart failure with reduced ejection fraction, who underwent modified radical mastectomy with left axillary lymph nodes dissection.

CONCLUSION

Combining TPVB-ISB can be used as a sole anesthetic for extensive breast surgery in patients with a high risk for general anesthesia.