Background and Goal of Study:
Breast surgery has undergone changes in recent years, encouraging new initiatives for the anaesthetic management. Emerge of the ultrasound as a common tool in regional anaesthesia (RA) has allowed the description and the improvement of the techniques used in there surgeries. The aim of the study is to consider including RA in breast surgery in our clinical practice.

Materials and Methods:
In this observational retrospective study we collected data from patients under breast surgery suspicious of malignancy from March to October 2017 in our hospital. Benignant pathology was excluded. Each anaesthesiologist decided which technique was performing in every case.
We analysed sex, age,type of surgery,type of anaesthesia,regional technique used (epidural, Pectoral blockade (PEC) 1 and 2, interfascial blockade(BRILMA)),administered drugs, PONV prophylaxis, immediate postoperative PONV, immediate postoperative pain, pain in two month and length of hospital stay.

Results and Discussion:
Study included 77 patients, 3 of them were excluded because of missing data (Figure 1). From 53 patients submitted to General anaesthesia (GA), 30 had immediate postoperative pain (56%), however 4 patients from 21 submitted to combined anaesthesia (GA+RA) had immediate pain (19%).
Analysing pain in two months, patients in the RA group was 4’7%. On the other hand, GA group was the 20%.
There were no differences in PONV. In all cases we followed Apfel scale to apply PONV prophylaxis.
The length of hospital stay was independent from the type of anaesthesia applied.
We had no case of systemic toxicity of local anesthetic (LA), neither pneumothorax. In all cases the regional blockade was performed with ultrasound.
One inconvenient of our study is that there was no standardized anaesthesia for this kind of surgeries.

Conclusion(s):
Although more cases are needed to have strong recommendations, our information suggests that chest wall blocks are a great option in these patients, safe, effective and not difficult to realize in our clinical practice. We are on the way to protocolize anaesthesia for these surgeries in our hospital based in our study.

07 / Anaesthesia for breast surgery, clinical practice in our hospital.