We described the first ultrasound-guided erector spinae plane block that provided complete surgical anesthesia for a right-sided mastectomy and axillary dissection in a patient with high cardiovascular risk. The block targeted at T5, and 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 and dexamethasone 8 mg was administered. Complete anesthesia was accomplished in 20 minutes, and the patient received propofol infusion for sedation. The patient reported no pain and remained hemodynamically stable throughout the 2.5-hour procedure. At the end of the surgery, patient received morphine 2 mg and dipyrone 2 g intravenously, and demanded no analgesic until 24 hours after the procedure.
From the *Department of Anesthesia, Instituto de Ensino e Pesquisa, Hospital Sírio Libanês, São Paulo, Brazil
†Department of Anesthesia and Pain Management, University Health Network, Toronto, Ontario, Canada
‡Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
§Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Accepted for publication March 5, 2018.
The authors declare no conflicts of interest.
Address correspondence to Pedro Paulo Kimachi, MD, Department of Anesthesia, Instituto de Ensino e Pesquisa, Hospital Sírio Libanês, Rua Prof. Daher Cutait, 69 - Bela Vista, São Paulo 01308, Brazil. Address e-mail to firstname.lastname@example.org.