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ESRA19-0313 Ultrasound-guided erector spinae plane (US-ESP) block associated with dexmetomidine cooperative sedation for anesthetic management in breast cancer surgery: a case report
  1. C Giordano1,
  2. S Ranocchia2,
  3. D Nicolotti1,
  4. P Fusco3,
  5. V Danzi1 and
  6. P Scimia1
  1. 1Hospital of Cremona, Anesthesia and Intensive Care Unit, Cremona, Italy
  2. 2University Hospital of Parma, Anesthesia and Intensive Care Unit, Parma, Italy
  3. 3S. Salvatore Academic Hospital of Aquila, Anesthesia and Intensive Care Unit, Aquila, Italy


Background and aims Ultrasound-guided erector spinae plane block (US-ESPB) is a recently described regional block technique for anesthesia and analgesia of the chest wall. Dexmetomidine (DEX) is an α-2 agonist that can provide cooperative sedation during surgery. We reported a case of US-ESPB associated to intraoperative DEX sedation in a patient undergoing breast cancer surgery.

Methods A 42-year-old patient, ASA 2, was scheduled to undergo quadrantectomy with sentinel lymph node biopsy. Before surgery, we performed a US-ESPB and 20 ml of 0,5% Ropivacaine were injected using a 90 mm needle (Temena®) deep to the erector spinae muscle and superficial to T5 transverse processes. The patient received intravenously DEX in a loading dose of 1 mcg/kg over 15 minutes, followed by an infusion of 0,4 mcg/kg/h and oxygen (4 l/min) was administered by facemask.

Results We obtained adequate surgical anesthesia and a good quality postoperative analgesia. Moreover, DEX infusion provided cooperative sedation during surgery (Ramsay 3) without causing respiratory depression of the patient. Only 3 g of acetaminophen were administered postoperatively. No complications were recorded.

Conclusions This case report suggested that US-ESPB associated to intraoperative DEX cooperative sedation could represent a reliable strategy for anesthetic management in breast surgery.

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