A&A practice
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Neuroendocrine tumors may rarely present after organ transplantation, including cardiac transplant. Treatment is surgical resection with careful perioperative management to optimize blood pressure and intravascular volume. We present the anesthetic management of a patient who was diagnosed with bilateral neuroendocrine tumors soon after heart-lung transplantation and underwent successful staged bilateral adrenalectomy.
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Postmastectomy pain syndrome poses a significant treatment challenge. We present the case of a 42-year-old woman who presented to our pain clinic with a 16-month history of postmastectomy pain. We performed a combined superficial and deep serratus plane block using bupivacaine, dexamethasone, and clonidine. ⋯ At 2-month follow-up, her pain was 5/10. The block was repeated with the same drugs at 3 months with similar pain relief. This case illustrates the utility of a combined superficial and deep serratus plane block in postmastectomy pain syndrome with a possible benefit from added dexamethasone and clonidine.