Paravertebral somatic nerve blocks for breast surgery in a patient with hypertrophic obstructive cardiomyopathy.

Journal Article (Journal Article)

PURPOSE: Patients with hypertrophic obstructive cardiomyopathy (HOCM), a genetic disorder resulting in idiopathic myocardial thickening, can present the anesthesiologist with significant management difficulties. This report reviews the physiology of this important disease process and describes the use of paravertebral nerve blocks (PVB) in the management of a patient with HOCM who presented for partial mastectomy with axillary lymph node dissection. CLINICAL FEATURES: A 72-yr-old female presented for breast cancer surgery with a significant past medical history of HOCM diagnosed during hospitalization for non-small cell lung cancer. PVB were performed at thoracic levels 1-6 and 5 mL of 0.5% ropivacaine and epinephrine 1:400,000 was injected at each level. Intraoperatively the patient required no other medication for analgesia and was comfortable and conversant during the two-hour procedure. She remained pain free following the operation and did not require any opioid medication until the following day. CONCLUSIONS: PVB provide excellent analgesia and are a useful alternative anesthetic when faced with the HOCM patient requiring major breast surgery.

Full Text

Duke Authors

Cited Authors

  • Buckenmaier, CC; Steele, SM; Nielsen, KC; Klein, SM

Published Date

  • 2002

Published In

Volume / Issue

  • 49 / 6

Start / End Page

  • 571 - 574

PubMed ID

  • 12067868

International Standard Serial Number (ISSN)

  • 0832-610X

Digital Object Identifier (DOI)

  • 10.1007/BF03017383


  • eng

Conference Location

  • United States