@article {2328, title = {Ganglion Impar Block and Neurolysis for Perineal Pain in Anal Adenocarcinoma: A Case Report }, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {June 2024}, pages = {711-715}, type = {Case Report}, chapter = {711}, abstract = {

Background: Anal adenocarcinoma is a rare malignancy with symptoms including tenesmus, rectal bleeding, and pain during defecation. The pain can significantly reduce a patient{\textquoteright}s quality of life and there is currently no effective treatment for it. Ganglion impar block and neurolytic are one methods for managing pain in such cases. Case: A 60-year-old woman with anal adenocarcinoma and chronic pain in the anal region for two years despite oral medication underwent ganglion impar block and neurolytic treatment using a mixture of 96\% alcohol and levobupivacaine 0.25\%. Conclusion: Ganglion impar block with neurolysis using 96\% alcohol can be an option for managing perineal pain, especially when previous medication therapy is ineffective. This combination is safe for patients and can reduce pain levels.

}, keywords = {Impar Ganglion Block; Neurolysis; 96\% Alcohol; Anal adenocarcinoma; Perineal pain; Pain management.}, doi = {10.5530/pj.2024.16.120}, author = {Asmaranto and Dedi Susila} } @article {2279, title = {Pectoralis Block in Geriatric Patients with Breast Cancer Undergoing Modified Radical Dextra Mastectomy}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {April 2024}, pages = {492-494}, type = {Case Report}, chapter = {492}, abstract = {

Regional anesthesia has the advantage of minimal use of drugs capable of depressing cardiovascular or pulmonary function, especially in geriatric patients. The pectoral nerve block represents a regional procedure associated with fewer adverse effects compared to alternative regional anesthetic approaches. A 74-year-old woman with a weight of 35 kg and a height of 145 cm, was diagnosed with breast cancer. The patient complained of a lump in the right breast since the last 1 year, the lump felt hard and didn{\textquoteright}t feel painful. We conducted PECS I and PECS II blocks as part of the surgical protocol for dextra Modified Radical Mastectomy (MRM), with the primary goal of minimizing the requirement for opioids and anesthetic agents in the context of geriatric patients. In the PECS I block, we introduced a needle into the anatomical plane situated between the pectoralis major and pectoralis minor muscles, followed by the injection of 10 mL of 0.5\% ropivacaine. In the case of the PECS II block, we administered a 20 mL dosage of ropivacaine at the third rib level above the serratus anterior muscle to ensure a wide distribution of the local anesthetic within the axillary region. The complete PECS block procedure typically spans a duration of approximately 30 minutes. The block was smooth and did not show complications, during the duration of the opioid, fentany 25 mcg was added during the axillary lymph node dissection. VAS scores at first 12 and 24 hours, 1 and 1. Thus, the PECS block can be used as an analgesic either during or postoperatively. The use of PECS 1 and 2 blocks in radical mastectomy may reduce the need for opioids for intraoperative and postoperative pain.

}, keywords = {Breast cancer, Geriatrics, Modified Radical Mastectomy (MRM), PECS Block}, doi = {10.5530/pj.2024.16.78}, author = {Ardhian Wardana and Dedi Susila} }