大動脈弁置換術後乳癌患者の乳房切除術を胸壁ブロック併用全身麻酔で管理した症例

Thoracic wall block is a useful tool for analgesia in a patient receiving mastectomy. To select an analgesic method with sufficient analgesic effect and little influence on cardiovascular dynamics is important for perioperative management of the patients whose cardiovascular dynamics are desirable to be stable. We experienced a patient who had an increased pressure gradient from the left ventricle to the aortic valve, accompanied by the sigmoid shaped ventricular septum developed after aortic valve replacement. By using pectoral nerve block and transversus thoracic muscle plane block combined with general anesthesia, we managed this patient uneventfully and safely.