Early surgical reintervention for haemostasis after breast surgery using persistent sensory block of a paravertebral block

摘要

Editor-The use of analgesic thoracic paravertebral block (PVB) for breast cancer surgery is well established. We report a case with a sensory block that persisted long enough for an emergency reintervention. The patient gave approval to publish her case. A 60-yr-old female patient was undergoing surgery on a breast carcinoma. An elective breast tumour resection with radioisotope-guided sentinel lymph node biopsy under general anaesthesia associated with analgesic PVB was planned. Her medical history had no bleeding reported. The blood tests did not find any preoperative thrombocytopenia or abnormal haemostasis (PT 100%, aPTT 30 s). The PVB was performed on the conscious patient in the left lateral decubitus position at the T3-4 thoracic space right level just before induction of general anaesthesia. After skin disinfection and the use of sterile gloves, an injection of 20 ml ropivacaine (7.5 mg ml~(-1)) (Ropivacaine Kabi?, Fresenius Kabi, Sevres, France) was given via a 22 Gx80 mm needle (SonoTAP cannula, Laboratoire Gamida Pajunk, Geisingen, Germany).