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| 乳腺癌患者术前超声引导下胸椎旁神经阻滞与术后慢性疼痛的相关性 |
| Association between preoperative ultrasound-guided thoracic paravertebral block and chronic postsurgical pain after breast cancer surgery |
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| DOI：10.12089/jca.2021.06.015 |
| 中文关键词: 术后慢性疼痛 胸椎旁神经阻滞 乳腺癌 |
| 英文关键词: Chronic postsurgical pain Thoracic paravertebral block Breast cancer |
| 基金项目: |
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| 摘要点击次数: 2058 |
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| 中文摘要: |
目的 采用倾向性评分匹配法（PSM）评估术前超声引导下胸椎旁神经阻滞（TPVB）与术后1年以上乳腺癌患者术后慢性疼痛（CPSP）的相关性。
方法 回顾性收集2018年1月至2019年3月全麻下择期乳腺癌手术女性患者的临床资料，ASA Ⅰ—Ⅲ级。根据是否接受术前超声引导下TPVB将患者分为两组：TPVB联合全麻组（TG组）和单纯全麻组（G组）。采用PSM法对患者资料进行匹配，对患者进行电话随访，评估CPSP的发生情况，并采用ID-Pain量表评估神经病理性疼痛（NP）。
结果 PSM匹配后两组各纳入患者148例。TG组CPSP发生率为64例（43.2%），G组CPSP发生率为50例（33.8%），两组差异无统计学意义。TG组中重度疼痛发生率低于G组，NP发生率高于G组，但差异无统计学意义。TG组CPSP的中位NRS评分为2（1～3）分，G组为2（1～4）分，两组差异无统计学意义。
结论 术前超声引导下TPVB与乳腺癌术后1年以上患者CPSP发生率降低无明显相关性。 |
| 英文摘要: |
Objective To evaluate the influence of preoperative ultrasound-guided thoracic paravertebral block (TPVB) on chronic postsurgical pain (CPSP) more than one year after surgery in breast cancer patients using propensity score matching.
Methods Electronic medical records of patients who underwent elective breast cancer surgery between January 2018 and March 2019 were reviewed. The patients were grouped according to whether preoperative ultrasound-guided TPVB was used for surgery: TPVB combined general anesthesia group (group TG) and simple general anesthesia group (group G). Propensity score matching was used to obtain between group balance. Telephone surveys regarding CPSP were conducted were among propensity matched patients where ID-Pain was used to assess neuropathic pain (NP).
Results After propensity matching, 148 patients were included in each group. There was no significant difference in the incidence of CPSP between the two groups, with 64 patients (43.2%) in group TG and 50 patients (33.8%) in group G. The incidence of moderate and severe pain in group TG was lower than that in group G, and the incidence of NP was higher than that in group G, but the difference was not statistically significant. The CPSP NRS score in group TG was 2 (1-3) points, and the CPSP NRS score in the G group was 2 (1-4) points. The CPSP pain levels of the two groups were mild pain, and the difference was not statistically significant.
Conclusion There is no association between preoperative ultrasound-guided TPVB and reduced incidence of CPSP more than one year after surgery in breast cancer patients. |
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