ABSTRACT : Oncological breast surgeries are commonly performed under GA, however in patients with poor pulmonary reserve, poor cardiac function and severe LRI where we cannot wait due to tumour progression, TEA can be given as a safe alternative to GA. Additionally TEA provides good post operative pain relief, lesser incidence of PONV and better anesthetic recovery.

METHODS : In five patients with poor cardiopulmonary reserve undergoing MRM, continuous TEA catheter was inserted at T4-T5 level with tip at T2 and 10-12 ml of 0.5% bupivacaine was given. Level and adequacy of blockade, hemodynamics, perioperative anaesthetic complications were monitored. Post operative analgesia maintained with 0.125% bupivacaine.

RESULTS : All five patients had no intra and post operative complications, no clinical variations in hemodynamics and had adequate anaesthesia and analgesia.

CONCLUSIONS : TEA is a safe and reliable alternative for GA in MRM patients with poor cardiopulmonary reserve providing faster anaesthetic recovery and less incidence of peri operative complications.