Breast lumpectomy
Anesthesia type

MAC or General

Airway

LMA/ETT if GA

Lines and access

PIV

Monitors

Standard

Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative

PONV

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A breast lumpectomy is the removal of a discrete portion or “lump” of breast tissue. This procedure is sometimes referred to as a partial mastectomy.

Sometimes the procedure is performed with wire localization, where a radiologist inserts the tip of a wire into the target tissue under fluoroscopic guidance preoperatively. This enables the surgeon to more precisely localize the lesion, and is more commonly performed for deeper lesions.

Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

  • PIV x 1
  • Place BP cuff off the surgical field
  • Make sure EKG leads are not near the sterile field

Induction and airway management

Positioning

  • Supine
  • Arms out

Maintenance and surgical considerations

  • Consider TIVA or partial TIVA, due to higher risk of PONV (patient population tends to be older females, who are at higher risk of PONV) and faster emergence.

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants

Superficial Deep
Unique considerations More likely MAC More likely GA
Position
Surgical time 15-45 mins 30-60 mins
EBL 5-10cc 5-10cc
Postoperative disposition
Pain management
Potential complications

References