Breast Excisional Biopsy and Ultrasound Needle Localization

Anesthesia Implications

Position: Reverse Trendelenburg
Time: 30-60 min (short)
Blood Loss: Very Low (5-10 ml)
Post-op Pain: Minimal (1-3)
Maintenance Paralytic: No

High stimulation – Incision/probing on the breast is very stimulating. To keep the patient from moving, make sure to have the patient deep enough at this junction.

Ace Bandage – Patient will likely be manually sat up by staff at the end of the procedure to ACE bandage the chest

Reverse Trendelenburg Position (general considerations): Improves access to the organs of the upper abdomen. To avoid patient slipping, use a foot board if an extreme angle is used. This position results in blood pooling in the abdomen and lower extremities. Reductions will be seen in stroke volume, cardiac filling, and cardiac output. The greater the angle, the greater these affects. Increases will be seen in FRC and compliance, which will be especially the case with obese patients. Ulnar nerve injuries can result if pressure is placed on the ulnar groove at the elbow. Any ‘bump’, rise, or IV pole along on the arm board between the elbow and the shoulder can result in radial nerve injury. Pad all pressure points (emphasis on head, sacrum, elbows, and heels) and ensure any straps used to secure limbs are loose enough to allow normal blood flow. Ensure the patient is not lying on IV tubing, monitor lines, or knots