Cervical Epidural Anaesthesia for Radical Mastectomy and Chronic Regional Pain Syndrome of upper limb-A Case Report

Indian J Anaesth. 2009 Dec;53(6):696-9.

Abstract

A 47-yrs-female patient presented with carcinoma right breast, swelling and allodynia of right upper limb. radical mastectomy with axillary clearance and skin grafting was done under cervical epidural anaesthesia through 18G epidural catheter placed at C6/C7 level. Postoperative analgesia and rehabilitation of affected right upper limb was managed by continuous epidural infusion of 0.125% bupivacaine and 2.5 microg/ml(-1)clonidine solution through epidural catheter for 5 days and physiotherapy. This case report highlights the usefulness of cervical epidural analgesia in managing a complex situation of carcinoma breast with associated periarthitis of shoulder joint and chronic regional pain syndrome (CRPS) of right upper limb.

Keywords: CRPS (chronic regional pain syndrome); Carcinoma breast; Cervical epidural anaesthesia (CEA); epidural Clonidine.