Breast Debridement Under Segmental Spinal Anaesthesia in a Low Resource Setting: Feasibility and Safety Concerns

Vol 8 | Issue 3 | September-December 2022 | Page: 00-00 | Shailendra Upadhyay, Imran Ahmed Khan, Shiv Kumar Singh

DOI: 10.13107/jaccr.2022.v08i03.000


Author: Shailendra Upadhyay [1], Imran Ahmed Khan [2], Shiv Kumar Singh [3]

[1] Department of Anaesthesiology, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
[2] Trauma Centre, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
[3] Department of Anaesthesiology, Royal Liverpool University Hospitals, Liverpool, UK.

Address of Correspondence
Dr. Imran Ahmed Khan
Senior Resident, Trauma Centre, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
E-mail: ikhan0046@gmail.com


Abstract


General Anaesthesia (GA) can be safely performed for most of the surgical procedures. However, in a small subset of patients, procedure or patients’ specific factors will dictate the choice of technique and regional anaesthesia (RA) may offer safer option. Subarachnoid Block can be performed at any of the thoracic and lumbar spinal levels, but is considered safer if it is performed below the termination of the spinal cord to avoid iatrogenic injury to the cord itself. Thoracic segmental spinal anaesthesia has been described in several groups of patients for e.g. laparoscopic cholecystectomy, abdominal cancer, breast cancer surgeries and other procedures. Patient refusal to any kind of procedure is an absolute contraindication. Under such circumstances we either counsel the patient, explain the procedure and risk involved and if options are available, alternative procedure/techniques are offered, for e.g., nerve blocks for lower or upper limb procedure are offered where GA is refused or contraindicated. We report a case of breast debridement performed under thoracic segmental spinal with excellent patient and surgeon satisfaction. Stable perioperative hemodynamics were maintained throughout the peri-operative period. Patient had refused general anaesthesia and we anticipated difficult airway. In our case, segmental thoracic spinal anaesthesia was offered and accepted by the patient. It was successfully performed with an adequate level of the sensory block during the breast debridement. The technique was associated with stable cardio-respiratory parameters and high patient satisfaction.
Keywords: Regional Anaesthesia, Segmental Spinal, Thoracic Spinal Anaesthesia


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How to Cite this Article: Upadhyay S, Khan IA, Singh SK Breast Debridement Under | Segmental Spinal Anaesthesia in a Low Resource Setting: Feasibility and Safety Concerns | Journal of Anaesthesia and Critical Care Case Reports | September-December 2022; 8(3): 00-00.

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