Abstract
Background: Carcinoma breast is the most common malignancy in Indian women which has recently overtaken cervical carcinoma as leading cause of cancer related morbidity and mortality. In India the incidence of carcinoma breast had been traditionally lower than in developed world. Some of this low incidence may have been due to lack of screening programs but lifestyle, reproductive and dietary factors also had a favorable outcome on low incidence. But this scenario is fast changing and along with change in life style in developing countries, awareness in general public and availability of equipments to detect the disease at peripheral health centers may be the reasons for increase in the incidence of carcinoma breast. Surgeries for carcinoma breast like simple or radical mastectomy are usually done under general anaesthesia. Spinal anaesthesia for mastectomies appears to be a promising new trend having advantage of decreased morbidity, less complications and early recovery.
Aims and Objectives: (1) To evaluate utility of unilateral subarachnoid block for surgeries for carcinoma breast and to study amount of analgesic and anesthetic drug if required. (2) To study complications associated with subarachnoid block in surgeries for carcinoma breast.
Materials and Methods: This was a prospective study conducted at a medical college in an urban area. Patients who had undergone surgeries for neoplastic breast diseases (carcinoma, breast phyllodes tumor) under unilateral subarachnoid were included in the study after considering inclusion and exclusion criteria of the study. Age, sex, weight, any associated co-morbidity and ASA status of the patients were recorded. For subarachnoid block inj. bupivacaine (0.5%) 2.8 ml with 0.2ml (60mcg) inj. buprinorphine were used. Events during surgery, hemodynamic stability and complications were studied.
Results: Total 90 patients were given unilateral subarachnoid block for their respective neoplastic breast diseases. 8 patients required conversion to general anaesthesia hence were excluded from the study. Out of 82 cases 47 cases were of simple mastectomy and 35 were of Modified radical mastectomy with Axillary dissection .Out of these 35 cases 15 cases required IV sedation. Out of 47 simple mastectomy cases none required additional analgesia. Inj.mephentermine for hypotension and inj Atropine for bradycardia had to be used in 35 and 3 patients respectively. No patient required intubation. Recovery was excellent in all the cases.
Conclusion: Unilateral subarachnoid block is a novel method of anaesthesia during surgeries for breast tumours. It is relatively safe and associated with good muscle relaxation and less blood loss.
Keywords: unilateral subarachnoid block, Carcinoma Breast, Complications and Outcome.
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Corresponding Author
Dr Sarfaraz Ahmed
Assistant Professor, Dept of Anesthesia Dr Shankarrao Chavan Govt Medical College Nanded – India
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.118
