Thoracic epidural block - A sole anasthetic procedure for breast surgeries

Introduction: Breast cancer is one of the most common cancers in middle and old aged females. Oncological breast surgeries have commonly been performed under General Anaesthesia (GA). Thoracic Epidural Anaesthesia (TEA) is a safe and advantageous technique associated with fewer post surgical recovery complications, shorter hospital stay and consequently, decreased health care costs. TEA provides better control of pain and provides satisfactory analgesia in postoperative period without any respiratory complications. Materials and Methods: A prospective study was carried out in Anaesthesiology and Critical care department of Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur (C.G.) in 40 female patients aged between 30 and 60 years with ASA grade I, II, III underwent for breast surgeries during February 2007 to July 2008. Pre operative assessment of the patient including history, clinical examination and relevant investigations were done. Pre operative assessment of the patient including history, clinical examination and relevant investigations were done. Explanation regarding procedure and consent was taken from all the patients. The procedure and techniques were performed as per standard protocol. Observations: Maximum numbers of cases (32 cases, 80%) were in the age group of 45-60 yrs. Mean age in our study was 49.0 ± 6.6 yrs. The mean duration of onset of block was 7.67±1.14min. The mean duration was 117.12±28.90min. In maximum number of patients (21), duration of surgery was 91-120 min and mean duration of surgery was 123.1.±13.16min.Preoperative mean SBP was 120 ± 7.45mm of Hg. Intraoperative SBP ranged from 119.8 ±7.02mm of Hg to 125.15 ±8.43mm of Hg. Preoperative mean DBP was 77.6 ±4.34mm of Hg. Introperative DBP ranged from 71.±5.61mm of Hg to 77. ±4.63mm of Hg. Preoperative mean of PR was 84.1 ±5.12/min. Intraoperative mean PR ranged from 80.4 ±4.41/min to 83.35 ±4.54/min and minimum PR was 80.4 ±4.41/min. Preoperative mean of RR was 14.52 ±1.3/min. It ranged between 13.35 ±0.97/min to 14.27 ±0.93/min. Conclusion: It is concluded that TEA for breast surgeries is a safe and a reliable alternative of GA.