摘要
目的探讨超声引导下胸壁神经阻滞在乳腺癌改良根治术中的应用价值。方法选取大连市中心医院2019年6月~2020年4月收治的全身麻醉气管插管下实施乳腺癌改良根治术患者80例为研究对象,按照随机数字表法分为观察组(40例)和对照组(40例)。观察组采用超声引导下胸壁神经阻滞,对照组患者采用超声引导下胸椎旁神经阻滞。比较两组麻醉复苏时相关指标,麻醉苏醒时疼痛主观及客观指标及术后48 h内镇痛效果。结果观察组患者恢复呼吸时间、恢复意识时间和拔除气管导管时间均短于对照组,差异有统计学意义(P<0.05)。麻醉苏醒时,观察组疼痛数字评分(NRS)评分低于对照组,且血清P物质(SP)及血清神经肽(NPY)水平均低于对照组,差异有统计学意义(P<0.05)。观察组术后镇痛泵追加按压次数少于对照组,且追加按压间隔时间长于对照组,差异有统计学意义(P<0.05)。结论针对乳腺癌改良根治术者,应用超声引导下胸壁神经阻滞,可提供确切的镇痛效果,减少术后阿片类药物使用剂量,提高麻醉苏醒质量。
Objective To explore the application value of ultrasound-guided thoracic wall nerve block in modified radical mastectomy for breast cancer.Methods A total of 80 patients underwent modified radical mastectomy for breast cancer under general anesthesia and endotracheal intubation in Dalian Central Hospital from June 2019 to April 2020 were selected as the research subjects.They were divided into an observation group(40 cases)and a control group(40 cases)according to the random number table method.The observation group received ultrasound-guided thoracic wall nerve block,and the control group received ultrasound-guided thoracic paravertebral nerve block.The relative indexes of anesthesia resuscitation,subjective and objective indexes of anesthesia resuscitation and analgesic effect within 48 hours after anesthesia were compared between the two groups.Results The recovery time of breathing,consciousness and tracheal catheter removal time were shorter in the observation group than those in the control group,the differences were statistically significant(P<0.05).When they woke up from anesthesia,the numerical rating score(NRS)of the observation group was lower than that of the control group,and the serum levels of substance P(SP)and serum neuropeptide(NPY)were lower than those of the control group,the differences were statistically significant(P<0.05).In the observation group,the frequency of additional pressure on postoperative analgesia pump was less than that in the control group,and the interval of additional pressure was longer than that in the control group,the differences were statistically significant(P<0.05).Conclusion For breast cancer patients undergoing modified radical mastectomy,the application of ultrasound-guided thoracic wall nerve block can provide definite analgesic effects,reduce postoperative opioid dosage,and improve the quality of resuscitation after anesthesia.
作者
常毅
田雨
CHANG Yi;TIAN Yu(Department of Anesthesiology,Dalian Central Hospital,Liaoning Province,Dalian116033,China)
出处
《中国当代医药》
CAS
2021年第3期168-170,174,共4页
China Modern Medicine
关键词
超声引导
胸壁神经阻滞
胸椎旁神经阻滞
乳腺癌改良根治术
Ultrasound guidance
Thoracic wall nerve block
Thoracic paravertebral nerve block
Modified radical mastectomy for breast cancer
