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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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Chapter 32 – Breast Block

PERSPECTIVE

There is increasing emphasis on carrying out “lesser” surgical procedures for breast cancer. These lesser procedures often involve lumpectomy or simple mastectomy and avoid the extensive chest wall procedures that in the past also involved shoulder structures. For this reason, breast blocks may become more appropriate for women undergoing operations for breast cancer.

Patient Selection.

Any individual requiring a breast surgical procedure is a candidate for breast block, although appropriate sedation for the block and procedure must be constantly kept in mind.

Pharmacologic Choice.

The breast block is designed to provide sensory block rather than motor block. For this reason, lower concentrations of local anesthetic are possible. For example, 0.75% to 1% lidocaine or mepivacaine is possible, and 0.25% bupivacaine is appropriate.

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