CONGRESS ABSTRACT

Introduction: Breast cancer is the most common type of cancer worldwide. Heart failure (HF) is a complex clinical syndrome caused by a structural or functional heart disorder. Patients with heart failure have increased risk for adverse cardiac events following non-cardiac Surgery.   Material and Methods We report the experience of our breast surgery unit. In 2024 we performed more then 200 breast cancer surgery. 65% were quadrantectomy with sentinel lymph node biopsy and 22% Mastectomy, in 62% of the cases associated to reconstruction. Approximately 30 % of our patients were over 65 and of these 50% were diagnosed moderate to severe heart failure. In these patients we preferred a locoregional approach. Using an ultrasound guidance, to  reduce the risk of inappropriate absorbance of local anesthetic, we performed fascial plane block such as interpectoral block, serratus plane block and parasternal block, associated with a conscious sedation. In this way we minimized risk for adverse cardiac events related to general anesthesia. Furthermore regional anesthesia is associated to lower recurrence of postoperative nausea and vomiting and  postoperative pain.   Conclusions: Regional anesthesia as a primary anesthetic can offer merits over general anesthesia in patient with heart failure in oreder to reduce risk related to general anesthesia and also give a higher rate of satisfaction to the patient.