Abdulkadir YEKTAŞ, Güneş Ülkü ÜLGER, Mevlüt ÇÖMLEKÇİ, Hacer YETER, Funda GÜMÜŞ, Kerem ERKALP, Ayşin ALAGÖL

Yüksek riskli mastektomi olgusunda torasik epidural anestezi-interskalen blok kombinasyonunun uygulanması: Olgu sunumu

Cerrahi ve anestezi tekniklerindeki gelişmeler, yüksek riskli hastaların anestezi alma ve ameliyat olabilme ihtimalini de beraberinde getirmektedir. Meme kanseri cerrahisinde genel anestezi tercih edilen başlıca yöntem olmasına rağmen, alternatif olarak rejyonel anestezi teknikleri de uygulanabilmektedir. Rejyonel anestezi uygulamasının ameliyat sırasında stres yanıt ile ameliyat sonrası mortalite ve morbiditeyi azalttığı, ilave olarak beslenmenin ve mobilizasyonun erken başlamasında etkili olduğu bilinmektedir. Rejyonel anestezi tekniklerinden yüksek torasik epidural anestezi, servikal epidural anestezi ve paravertebral blok ile mastektomi ameliyatlarının başarı ile yapıldığı daha önceki çalışmalarda bildirilmiştir. Torasik epidural anestezi ile kombine yapılan interskalen blok tekniğide servikal epidural anestezi veya genel anesteziye iyi bir alternatif olabilir. Bu yazıda, pulmoner problemleri olan, torasik epidural anestezi ile kombine interskalen blok altında, mastektomi ve aksiller disseksiyon planlanan hasta sunuldu.

A case of combined thoracic epidural anesthesia-interscalene block application in high-risk mastectomy patients: a case report

Recent advances in surgical and anesthetic techniques have facilitated general anesthesia and surgical possibilities in the higher-risk patient group. Although general anesthesia is the only preferred approach for breast surgery, there have been many clinical trials about breast surgery that has been achieved with regional anesthesia techniques. It is known that regional anesthesia application decreases the preoperative stress, postoperative morbidity and mortality. Additionally, this application positively affects the early start of feeding and mobilization. Regional anesthesia techniques like high thoracic epidural anesthesia, cervical epidural anesthesia and paravertebral block have been applied successfully in mastectomy operations. Combined thoracic epidural anesthesia-interscalene block technique may also be a good alternative to general or cervical, high thoracic epidural anesthesia. We aimed herein to pres- ent a case who underwent successful mastectomy and axillary dissection under combined thoracic epidural anesthesia-interscalene block.

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