{
  "abstract": "Background and Aims General anesthesia remains the standard for breast cancer surgery; however, regional nerve blocks present a viable alternative in select patients. This retrospective review reports a series of five Filipino female patients who underwent awake breast surgery using ultrasound-guided nerve blocks. It highlights the challenges of dosing local anesthetics in smaller-bodied individuals and explores effective block combinations for surgical anesthesia.Methods Patient data from November 2024 to April 2025 were reviewed. All procedures were performed under sedation and ultrasound-guided nerve blocks. A multilevel thoracic paravertebral block was the main technique, combined with fascial plane blocks (interpectoral, pectoserratus, superficial serratus anterior, superficial parasternal) and intermediate cervical plexus blocks based on the surgical extent. Local anesthetic volumes and concentrations were adjusted per patient to stay within safe dosing limits.Results All five patients underwent surgery without conversion to general anesthesia. No block-related complications were reported. Total ropivacaine doses ranged from 2.6 to 3.0 mg/kg. Postoperative analgesia was managed with non-opioid medications; none required rescue analgesia.Conclusions Awake breast surgery using regional nerve blocks is feasible and effective in the Filipino population with appropriate dosing and block selection. This case series demonstrates promising outcomes and paves the way for a larger, prospective study to validate safety, efficacy, and reproducibility in a broader patient population.",
  "authors": [
    {
      "affiliations": [
        "Regional Anesthesia, St Lukes Medical Center- Global City, Taguig, Philippines"
      ],
      "name": "Isabella Tanada"
    },
    {
      "affiliations": [
        "Regional Anesthesia, St Lukes Medical Center- Global City, Taguig, Philippines"
      ],
      "name": "Samantha Claire Braganza"
    },
    {
      "affiliations": [
        "Regional Anesthesia, St Lukes Medical Center- Global City, Taguig, Philippines"
      ],
      "name": "Jacky Corpuz"
    },
    {
      "affiliations": [
        "Department of Surgery, St Lukes Medical Center- Global City, Taguig, Philippines"
      ],
      "name": "Wesley Daniel Advincula"
    }
  ],
  "title": "P235 A retrospective narrative review of nerve block techniques for awake breast surgery: a case series of awake breast surgeries in st luke’s medical center- global city",
  "uid": "ca02adc7-d725-51a4-afda-7a1a21a6a604"
}