• JA clinical reports · Jul 2019

    Pectoral nerve II block, transversus thoracic muscle plane block, and dexmedetomidine for breast surgery in a patient with achondroplasia: a case report.

    • Toshiyuki Nakanishi, Manabu Yoshimura, and Takashi Toriumi.
    • Department of Anesthesiology, Japan Community Healthcare Organization Tokuyama Central Hospital, 1-1, Koda-cho, Shunan, Yamaguchi, 745-8522, Japan. nakanishi.anest@gmail.com.
    • JA Clin Rep. 2019 Jul 19; 5 (1): 47.

    BackgroundPatients with achondroplasia have various airway deformations and spinal anatomic abnormalities; therefore, performing general anesthesia and neuraxial anesthesia in such patients can be challenging.Case PresentationA 56-year-old, 112-cm, 30-kg woman was scheduled to undergo partial mastectomy and sentinel lymph node biopsy for cancer of the right breast. She had short limbs, scoliosis, thorax deformation, and chronic moderate to severe mitral regurgitation of the mitral valve. We performed pectoral nerve II block and transversus thoracic muscle plane block and administered intravenous dexmedetomidine. The surgery was completed without the administration of any additional analgesics or sedatives.ConclusionsWe successfully performed breast surgery using pectoral nerve II block, transversus thoracic muscle plane block, and sedation with dexmedetomidine in a patient with achondroplasia. We found that the combination of peripheral nerve blocks is a useful option in patients who have difficulties with both general anesthesia and neuraxial anesthesia.

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