Combined thoracic epidural anaesthesia and interscalene brachial plexus block for modified radical mastectomy in a high-risk patient

In a case of malignancy of the breast, operation is one of best option for the management of the patient. Modified radical mastectomy (MMR) is commonly conducted by giving general anaesthesia (GA). But GA is not a rational choice in patients who are suffering from bronchial asthma and other associated comorbidities. These patients have additional danger of perioperative morbidity and mortality especially because of respiratory complications. We report successful perioperative management of MMR under combined thoracic epidural anaesthesia and ipsilateral interscalene brachial plexus block in a diagnosed case of malignancy of breast with bronchial asthma, type 2 diabetes mellitus and hypertension.