Korean J Anesthesiol.  2019 Jun;72(3):270-274. 10.4097/kja.d.18.00266.

Erector spinae plane block combined with a novel technique for selective brachial plexus block in breast cancer surgery: a case report

• De Cassai
• Bonvicini
• Ruol M
• Correale C
• Furnari M

• KMID: 2454887
• DOI: http://doi.org/10.4097/kja.d.18.00266

Abstract

BACKGROUND
The breast is innervated by the intercostal nerves and the brachial plexus. We propose a technique to perform breast surgery without general anesthesia using the erector spinae plane (ESP) block and selective block of four nerves that arise from the brachial plexus innervate the breast and the axilla (SBP block). CASE: A 77-year-old man with breast cancer was scheduled for radical mastectomy and axillary clearance. He had a previous history of myocardial infarction with dilated cardiomyopathy and severely impaired ejection fraction. The surgery was performed under regional anesthesia with combined ESP and SBP block. The patient did not require opioids or other supplemental analgesics intra- or postoperatively and was discharged uneventfully.
CONCLUSIONS
SBP is a novel block that selectively blocks branches of the brachial plexus that innervate the breast.

Keyword

Brachial plexus; Breast surgery; Erector spinae plane block; Regional anesthesia

MeSH Terms

Aged
Analgesics
Analgesics, Opioid
Anesthesia, Conduction
Anesthesia, General
Axilla
Brachial Plexus Block*
Brachial Plexus*
Breast Neoplasms*
Breast*
Cardiomyopathy, Dilated
Humans
Intercostal Nerves
Mastectomy, Radical
Myocardial Infarction
Analgesics
Analgesics, Opioid