Lumbar spinal anaesthesia for malignant breast surgeries revisiting an unconventional approach-A case series”

Breast surgeries are traditionally conducted under general anaesthesia however it

has its own constraints like airway complications high incidence of nausea and

vomiting and increased length of hospitalisation and cost this created demand for

better approaches like neuraxial anaesthesia

On exploring neuraxial techniques for breast surgeries thoracic epidural and

thoracic segmental spinal anesthesia showed promising results but these procedures

carried their own risks like hemodymaic instability potential spinal cord injury

respiratory compromise and technical challenges.

Lumbar spinal anaesthesia being simpler safer and more technically accessible

alternative which has been successfully tried for upper abdominal surgeries while

avoiding the complexities and neurological risk associated with thoracic spinal

block but its use in breast surgeries is limited

This study explores the feasibility of lumbar spinal anaesthesia in breast surgeries

including malignant with axillary dissection local anaesthetic administered in

lumbar subarachnoid space followed by barbotage to achieve controlled cephalad

spread satisfactory anaesthesia can be obtained up to required thoracic dermatomes

while ensuring good analgesia stable hemodynamics spontaneous respiration and

patient consciousness