Regional anesthesia for axillary lymph node excisional biopsy in a patient with anterior mediastinal mass

Regional blocks for the anterolateral chest wall are challenging in regard to the anatomical basics and innervation, the limitation of available evidence, lack of credible guidelines, and wide discrepancy in the existing practice among the health practitioners across the countries. Despite the challenges, recently new fascial plane blocks have been used more often as analgesic techniques. In very few occasions these techniques have been reported in literature as surgical blocks in certain cases where general anesthesia was not favorable or advisable. We present a challenging case in which the scheduled surgery had to be postponed due to high risk if done under general anesthesia, as she was concurrently suffering from multiple comorbidities and needed much status optimization. At the same time, her procedure was time sensitive to diagnose her medical illness and initiate the proper management. Keywords: Regional Anesthesia; Pain Management; Fascia Plane Block; Nerve Block Citation: Al Misnid O. Regional anesthesia for axillary lymph node excisional biopsy in a patient with anterior mediastinal mass. Anaesth. pain intensive care 2025;29(2):354-357. DOI: 10.35975/apic.v29i2.2729 Received: February 11, 2025; Reviewed: February 14, 2025; Accepted: February 16, 2025