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| 超声引导下前锯肌平面阻滞联合氟比洛芬酯预防乳腺癌术后疼痛综合征 |
| Ultrasound-guided anterior serratus planar block combined with flurbiprofen axetil in the prevention of pain syndrome after breast cancer surgery |
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| DOI：10.12089/jca.2019.11.008 |
| 中文关键词: 乳腺癌 乳腺癌术后疼痛综合征 前锯肌平面阻滞 氟比洛芬酯 |
| 英文关键词: Breast cancer Postmastectomy pain syndrome Serratus plane block Flurbiprofen axetil |
| 基金项目: |
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| 中文摘要: |
目的 观察超声引导下前锯肌平面阻滞联合氟比洛芬酯和单纯氟比洛芬酯进行术后镇痛的疗效,探讨超声引导前锯肌平面阻滞联合氟比洛芬酯在预防乳腺癌改良根治术后疼痛综合征的作用。
方法 选择2017年3月至9月在本院择期行乳腺癌根治术的女性患者120例,年龄30～82岁,BMI 18～30 kg/m2,ASA Ⅰ或Ⅱ级。采用随机数表法随机分为全身麻醉联合神经阻滞组(GB组)和全身麻醉组(G组),每组60例。GB组采用超声引导下0.375％罗哌卡因行前锯肌平面阻滞联合氟比洛芬酯镇痛,G组单纯静脉给予氟比洛芬酯静滴镇痛。 记录患者术后1、7 d，1、3、6、12个月的疼痛缓解情况,采用VAS评分评估。记录患者术后1、3、6个月的慢性疼痛发生情况。生活质量评价采用简明SF-36健康简明量表,包括生理功能、生理职能、躯体疼痛、总体健康、精神健康、活力、情感职能、社会功能8项评分。记录患者术后1、3、6、12个月SF-36生活质量指数8项评分。
结果 本研究共纳入患者120例,剔除4例后,两组分别有58例患者纳入研究。术后1、7 d，1、3、6、12个月GB组VAS评分明显低于G组(P < 0.05)。术后1、3、6个月GB组慢性疼痛发生率明显高于G组(P < 0.05),SF-36生活质量指数中生理功能、生理职能、躯体疼痛、总体健康、精神健康、活力、情感职能、社会功能8项评分均明显高于G组(P < 0.05)。
结论 超声引导前锯肌平面阻滞联合氟比洛芬酯可为乳腺癌改良根治术提供良好的术后镇痛,对预防乳腺癌术后疼痛综合征有效且安全性较高,适用于临床。 |
| 英文摘要: |
Ojective To study the effect of ultrasound-guided anteriorserratus planar block combined with flurbiprofen axetil on postoperative analgesia compared with flurbiprofen axetil alone, and to explore the role of ultrasound-guided anterior serratus planar block combined with flurbiprofen axetil in preventing pain syndrome after modified radical mastectomy for breast cancer.
Methods A total of 120 female patients aged 30-82 years, BMI 18-30 kg/m2, falling into ASA physical status Ⅰ or Ⅱ, who underwent selective radical mastectomy in our hospital from March to September 2017 were selected. The patients were randomly divided into general anesthesia combined with nerve block group (group GB) and general anesthesia group (group G), 60 cases in each group. 0.375％ ropivacaine was used for ultrasound-guided anterior serratus planar block combined with flurbiprofen axetil analgesia in group GB, while intravenous flurbiprofen axetil was singlelyused for intravenous analgesia in group G. Visual analogue scale (VAS) was recorded at 1, 7 d, 1, 3, 6 and 12 months after operation. The occurrence of chronic pain at 1, 3 and 6 months after operation were recored. The SF-36 quality of life index was used to evaluate the quality of life, including 8 scores of physcial function, role Physical, bodily pain, genearal health, meantal health, vitality, role emotional, social function. 8 scores of SF-36 quality of life index were recorded at 1, 3, 6 and 12 months after operation.
Results A total of 120 patients were enrolled in this study. After 4 cases were excluded, 58 patients in group GB and 58 patients in group G were included in the study. The VAS scores in group GB were significantly lower than those in group G at 1, 7 d, 1, 3, 6 and 12 months after operation (P < 0.05). The incidence of chronic pain in group GB was lower than that in group G at 1, 3 and 6 months after operation. The scores of SF-36 were significantly higher than those in group G (P < 0.05).
Conclusion Ultrasound-guided anterior serratus planar block combined with flurbiprofen axetil can provide good analgesia after modified radical mastectomyfor breast cancer. It is effective and safe for preventing pain syndrome after breast cancer surgery and is suitable for clinical application. |
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