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| 超声引导下胸部神经阻滞在乳腺癌改良根治术后多模式镇痛中的应用 |
| Analgesic effect and safety evaluation of PECS block under ultrasound guidance in multimodal analgesia after modified radical mastectomy |
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| DOI： |
| 中文关键词: 超声引导 胸部神经阻滞 全身麻醉 乳腺癌改良根治术 |
| 英文关键词: Ultrasound guidance Pectoral nerves block General anesthesia Modified radical mastectomy |
| 基金项目:陕西省国际科技合作与交流计划（2014KW21-03） |
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| 摘要点击次数: 4865 |
| 全文下载次数: 2004 |
| 中文摘要: |
目的 评价超声引导下胸部神经(pectoral nerves, PECS)阻滞在乳腺癌改良根治术后多模式镇痛中的有效性及安全性。
方法 择期行单侧乳腺癌改良根治术女性患者60例,年龄18～65岁,ASA Ⅰ或Ⅱ级。按随机数字表法分为两组:超声引导下PECS阻滞组(P组)和空白对照组(C组),每组30例。全身麻醉诱导后,P组患者在超声引导下实施PECS阻滞,给予0.375％罗哌卡因30 ml;C组患者不给予PECS阻滞。两组患者术前均给予静脉注射氟比洛芬酯1 mg/kg。两组患者在静-吸复合全身麻醉下完成手术。记录患者术毕苏醒即刻（术后0 h）、术后3、6、12和24 h静息状态下疼痛VAS评分;并记录术中瑞芬太尼用量、术后24 h内补救性镇痛药给予情况及术后不良反应发生情况。
结果 术后0、3、6和12 h VAS评分P组明显低于C组(P<0.05),术后24 h两组VAS评分差异无统计学意义。术中瑞芬太尼用量P组明显少于C组,术后24 h内镇痛药补救率P组明显低于C组(P<0.05)。两组患者术后不良反应差异无统计学意义。
结论 对于乳腺癌改良根治术患者,超声引导胸部神经阻滞作为多模式镇痛模式的辅助,可以提供更佳的术后镇痛效果,且安全可靠。 |
| 英文摘要: |
Objective To evaluate the efficacy and safety of PECS block under ultrasound guidance in multimodal analgesia after modified radical mastectomy.
Methods Sixty female patients aged 18-65 years, ASA grade Ⅰ or Ⅱ, undergoing elective unilateral modified radical mastectomy were enrolled. Patients were randomly divided into PECS group (group P, n=30) or control group (group C, n=30). Two groups of patients were given flurbiprofen axetil 1 mg/kg via intravenous injection before operation. After general anesthesia induction, patients in group P received ultrasound guided pectoral nerves block with 30 ml of 0.375% ropivacaine. Patients in group C didn't receive nerve block. Anesthesia maintenance was performed by combined intravenous-inhalation Anesthesia. Postoperative VAS pain scores (at 0, 3, 6, 12, and 24 postoperative hours), does of intraoperative remifentanil, rescue analgesic requirements in the first 24 h after surgery, adverse reactions were recorded.
Results VAS score in group P was lower than that in group C at 0, 3, 6 and 12 h after surgery (P<0.05), there was no difference at 24 h. The dose of remifentanil and the rescue analgesic requirements in group P were lower than those in group C (P<0.05). There was no significant difference in postoperative adverse reactions between the two groups.
Conclusion As a supplementary mode of multimodal analgesia, PECS block is a safe and reliable technique that provide better analgesia effect for modified radical mastectomy. |
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