摘要
目的:探讨超声引导下罗哌卡因用于胸壁神经阻滞Ⅰ(PECSI)联合锯齿-肋间平面阻滞(SPB)在乳腺癌改良根治术后镇痛的镇痛效果和安全性。方法:于2016年2月至2018年2月于我院行乳腺癌改良根治术患者80例。通过区组随机化分组法将80例患者分为PECSI联合SPB组(阻滞组)和仅行全身麻醉组(对照组),每组各40例患者。阻滞组在超声引导下给予0.5%罗哌卡因行PECSI联合SPB麻醉镇痛,两组患者诱导后行气管导管下静吸复合麻醉,对两组患者的镇痛效果和安全性进行对比。结果:与对照组相比,阻滞组术后不同时间(4h、8h、12h和24h)的疼痛视觉模拟评分(VAS评分)和每日睡眠干扰质量评分(DSIS评分)明显降低(均P<0.05)。阻滞组患者术后镇痛时间较长,镇痛满意度较高(均P<0.05)。对于术后恶心呕吐、皮肤瘙痒、眩晕等不良反应发生率,阻滞组较对照组显著降低(均P<0.05)。结论:超声引导下罗哌卡因用于PECSI联合SPB对乳腺癌根治术后镇痛具有较好的临床疗效和安全性,可在临床推广应用。
Objective:To investigate the effect of ultrasound-guided pectoral nerve block I and serratus-intercostal plane block alleviate postoperative pain in patients after modified radical mastectomy.Methods:80 patients with breast cancer who sought medical care in our hospital from Feb.2016 to Feb.2018 were enrolled and divided into PECSI block group(observation group)and only general anesthesia group(control group)via block randomized grouping method,40 cases in each group.The observation group had anesthesia combining PECSI with SPB.2 groups of patients had static absorption composite after anesthesia induction,the analgesic effect and safety were compared between the 2 groups of patients.Results:Visual analogue scale(VAS)after 4h,8h,12h and 24h of surgery and daily sleep disturbance quality score(DSIS)in the observation group were significantly lower than those in the control group(all P<0.05).Compared with the control group,patients in the observation group had a longer postoperative analgesia time and a higher degree of satisfaction with analgesia,and the difference was statistically significant(P<0.05).The incidence of postoperative adverse reactions,such as nausea and vomiting,skin itching and dizziness,was significantly lower in the observation group than in the control group(all P<0.05).Conclusion:Ultrasound-guided PECSI combined with SPB by ropivacaine has a significant analgesic effect on radical mastectomy,which can be promoted in clinical practice.
作者
杨坤渹
李扬
易勤美
YANG Kunhong;LI Yang;YI Qinmei(Minda Hospital Affiliated to Hubei University for Nationalities, Hubei Enshi 445000, China)
出处
《河北医学》
CAS
2021年第4期571-575,共5页
Hebei Medicine
基金
国家自然科学基金项目,(编号:2017-38-0137)。
关键词
胸壁神经阻滞Ⅰ
锯齿-肋间神经阻滞
术后镇痛
乳腺癌根治术
Pectoral nerve blockⅠ
Serrate intercostal nerve block
Postoperative analgesia
Radical mastectomy for breast cancer
