A 22-years-old female patient at 171 cm and 67 kg visited the Department of Breast Surgery of the hospital with a mass accompanied with pain on the left side breast as chief complaints. Since physical examination revealed a suspected huge mass, breast surgeon decided to perform surgical excision and requested anesthesia to our department. Surgery of breast tumor is often under local anesthesia. However, in case of big size tumor, surgery is usually performed under general anesthesia. The patient feared general anesthesia. Unlike abdominal surgery, there is no need to control visceral pain for breast and anterior thoracic wall surgery. Therefore, we decided to perform resection under regional anesthesia. Herein, we report a successful anesthetic and pain management of the patient undergoing excision of a huge breast fibroadenoma under regional anesthesia using Pecs II and internal intercostal plane block.
Anesthesia ; Anesthesia, Conduction* ; Anesthesia, General ; Anesthesia, Local ; Breast Neoplasms ; Breast* ; Female ; Fibroadenoma* ; Humans ; Mastectomy, Segmental ; Pain Management ; Physical Examination ; Thoracic Nerves ; Thoracic Wall ; Visceral Pain

Herpes zoster is an infectious disease of the dorsal root ganglion and sensory nerve fibers. Motor nerve involvement is a rare complication. Hiatal hernia occurs when the stomach protrudes into the thoracic cavity through the esophageal hiatus of the diaphragm. Herein, we present the case of a 78-year-old man with abdominal wall muscle paresis caused by herpes zoster, which resulted in a hiatal hernia.
Abdominal Muscles* ; Abdominal Wall ; Aged ; Communicable Diseases ; Diaphragm ; Ganglia, Spinal ; Hernia, Hiatal* ; Herpes Zoster* ; Humans ; Nerve Fibers ; Paresis* ; Stomach ; Thoracic Cavity