| Clinical Assessment of Thoracic Epidural Anesthesia for Breast Mass Excision. |
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Sang Hwan Do, Seong Ho Chang |
1Department of Anesthesiology, Seoul National University, College of Medicine, Seoul, Korea.
2Department of Anesthesiology, College of Medicine, Korea University, Seoul, Korea. |
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| Abstract |
BACKGROUND
Thoracic epidural anesthesia(TEA) is not commonly used for the purpose of pure regional anesthesia.
To investigate the usefulness of TEA as a method of regional anesthesia, we performed TEA in patients(n=20) with breast mass.
METHODS
After placement of thoracic epidural catheter at one of the 3rd, 4th, 5th or 6th thoracic intervertebral space according to the position of the mass, we injected 8ml of 2% plain lidocaine solution as initial dosage and 2~4 ml as additional dosage if necessary. Blood pressure and heart rate were measured before and at 5, 10, 15, 20, 25, 30, 60 and 90 minutes after epidural injection. Fifteen minutes after epidural injection, the extent of sensory block was measured at cephalad and caudad directions. Two-dermatome regression time was recorded postoperatively. We also investigated whether surgeon used lidocaine locally and anesthetist used intravenous analgesics or sedatives. And we observed the occurrence of complications associated with TEA.
RESULTS
The induction dose of 2% lidocaine was 10.1+/-2.1 ml and total dose used was 11.4+/-2.1 ml. The extent of sensory block was T1.1+/-1.1 to T9.1+/-2.3 and two-dermatome regression time was 73+/-24 minutes. Blood pressure and heart rate showed stable pattern of change perioperatively.
In two of the subjects, the surgeon used 4 ml of 1% lidocaine locally and in one of the subjects, 50 microgram of fentanyl was used intravenously. Another one of the subjects developed Horner's syndrome postoperatively, which soon disappeared without specific treatment.
CONCLUSIONS
Above results suggest that TEA is suitable for breast mass excision as a method of regional anesthesia. |
| Key Words:
Anesthetic techniques epidural; thoracic; Surgery mass excision; breast |
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