| Thoracic Epidural Anesthesia for Mastectomy. |
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Si Young Ok, Sung Won Park, Soon Im Kim, Sun Chong Kim, Min Hyuk Lee |
1Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, Seoul, Korea. syok2377@hanmail.net
2Department of General Surgery, Soonchunhyang University Hospital, Seoul, Korea. |
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| Abstract |
BACKGROUND
Segmental thoracic epidural anesthesia (sTEA) is commonly used for postoperative pain control in chest or upper abdominal surgery. But it is not commonly used for the purpose of pure regional anesthesia. Therefore we investigated the usefulness of sTEA for mastectomy and evaluated the effects of sTEA on respiration and hemodynamics.
METHODS
Twenty patients scheduled for mastectomy were randomly assigned. Under sitting position, epidural catheter was inserted at T3-4 or T4-5. 20 ml of 0.375% ropivacaine with fentanyl 50 microg was injected to maintain anesthesia.
The targeted sensory anesthetic dermatomal levels were determined by pinprick and measured at 5 min intervals for the first 15 min after injection of the drugs. If sensory block was not adequate, subsequent 5 ml doses of ropivacaine was injected. Supplemental oxygen (3-6 L/min) was administered through a face mask. After dermatomal level was checked, propofol infusion for sedation was started.
Arterial blood sampling was taken for ABGA.
RESULTS
Average sensory anesthetic dermatomal levels is C5.5 +/- 1.9 - T8.9 +/- 2.7. During surgery, hypotension was noted in 25% of patients. It was treated with ephedrine 6 mg i.v. Average PaCO2 is 47.9 +/- 7.7 mmHg.
CONCLUSIONS
Above results suggest that sTEA is suitable for mastectomy as a method of regional anesthesia. |
| Key Words:
mastectomy; ropivacaine; segmental thoracic epidural anesthesia |
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