Association of Multimodal General Anesthesia and Regional Block for Thoracic Interscapular Amputation in an Elderly Patient. Case Report.

Background: Proximal amputations of major limbs due to malignant tumors have become rare, but they are still a valuable treatment option for palliation and, in some cases, can even be curative. The aim of this case report was to analyze the outcome of interscapular-thoracic amputation in an elderly patient. Case Report: Male patient, 85 years old, BMI of 1.77 kg/m², ASA III, with systemic arterial hypertension using losartan 50 mg daily. Smoker and history of deep vein thrombosis. History of hand ulcers, evolving to ulceration and bleeding. Squamous cell carcinoma biopsy. Indicated thoracic interscapular amputation (TIA) under regional associated with multimodal general anesthesia. Interscalene and serratus anterior block with ropivacaine 0.5% and use of US. Postoperative period in the ward without pain. Evolved during the three days without pain complaints. Conclusion: TIA in an 85-year-old patient, as a primary or palliative procedure, may be justified after a careful holistic evaluation of the case. Interscalene brachial plexus block associated with the serratus anterior plane with 0.5% ropivacaine and complemented with multimodal general anesthesia allowed shoulder disarticulation with adequate safety for the patient and comfort for the surgical team, excellent postoperative analgesia and no complications.