Minimal Pain Tumescent Local Anesthesia Injection for Wide Awake Modified Radical Mastectomy

Area of Science:

• Oncology
• Surgical Anesthesia
• Patient Safety

Background:

• Modified radical mastectomy (MRM) with axillary lymph node dissection (ALND) is standard for breast cancer but often requires general anesthesia.
• General anesthesia poses significant risks for patients with severe medical comorbidities.
• Tumescent local anesthesia offers a safer alternative for wide awake procedures, improving patient safety.

Purpose of the Study:

• To present a case of a patient with significant comorbidities undergoing MRM and ALND under tumescent local anesthesia.
• To demonstrate the feasibility and safety of wide awake breast cancer surgery in high-risk patients.

Main Methods:

• A 78-year-old male patient with invasive ductal breast carcinoma, cardiac failure, and metabolic abnormalities was selected.
• The patient underwent a wide awake MRM and ALND using tumescent minimal pain local anesthesia injection.
• No sedation or general anesthesia was administered.

Main Results:

• The procedure was performed successfully and safely.
• The patient experienced minimal discomfort throughout the surgery.
• This highlights the efficacy of tumescent anesthesia in complex surgical cases.

Conclusions:

• Tumescent local anesthesia is a viable and safe option for MRM and ALND in patients with severe medical comorbidities.
• Wide awake surgery can be effectively performed, avoiding the risks associated with general anesthesia.
• This technique improves patient safety and outcomes in high-risk surgical populations.