摘要
目的 评价前锯肌平面阻滞(SPB)和胸椎旁神经阻滞(PVB)用于乳腺手术后镇痛效果。方法 检索Pubmed、Embase、Cochrane Library、中国知网、万方、维普等数据库,纳入比较SPB和PVB用于乳腺手术后镇痛效果的随机对照试验(RCT)。主要结局指标为术后不同时间点静息视觉模拟疼痛评分(VAS),次要结局指标为术后24 h吗啡需要量和恶心呕吐等不良事件发生率。采用RevMan 5.3软件进行Meta分析。结果 纳入9项RCT,共526例患者。Meta分析结果显示,SPB组术后6 h(MD 0.25,95%CI 0.11~0.39,P<0.05)、术后12 h(MD 0.63,95%CI 0.54~0.73,P<0.05)和术后24 h(MD 0.57,95%CI 0.26~0.88,P<0.05)VAS评分都高于PVB组;两组术后24 h吗啡需要量差异无统计学意义(MD 1.87,95%CI-2.32~6.07,P>0.05);SPB组术后恶心呕吐发生率高于PVB组(RR 1.81,95%CI 1.20~2.74,P<0.05)。结论 PVB应用于乳腺手术术后镇痛效果优于SPB,术后恶心呕吐发生率低。
Objective To evaluate the postoperative analgesia of serratus anterior plane block(SPB) and thoracic paravertebral nerve block(PVB) for patients after breast surgery.Methods Randomized controlled trials(RCT) were retrieved from the databases of Pubmed,Embase,Cochrane Library,CNKI,Wanfang and VIP.The primary outcome measures were VAS at rest after surgery at different time points,the secondary outcome measures were morphine consumption and the incidence of adverse events such as nausea and vomiting at 24 h after surgery.RevMan 5.3 software was used for Meta-analysis.Results A total of 9 RCT,526 patients were included.The results of Meta-analysis showed that the VAS scores at 6 h after surgery(MD 0.25,95%CI 0.11~0.39,P<0.05),12 h after surgery(MD 0.63,95%CI 0.54~0.73,P<0.05) and 24 h after surgery(MD 0.57,95%CI 0.26~0.88,P<0.05) in the SPB group were higher than those in the PVB group.There was no statistical difference of morphine consumption at 24 h after surgery between the two groups(MD 1.87,95%CI-2.32~6.07,P>0.05).The incidence of postoperative nausea and vomiting in SPB group was higher than that in PVB group(RR1.81,95%CI 1.20~2.74,P<0.05).Conclusion The analgesia effect of PVB is better than SPB after breast surgery,and the incidence of postoperative nausea and vomiting is low.
作者
肖万莉
陈永旺
刘玉林
唐霓
Xiao Wanli;Chen Yongwang;Liu Yulin(Department of Anesthesiology,The Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)
出处
《四川医学》
CAS
2022年第5期472-477,共6页
Sichuan Medical Journal
关键词
前锯肌平面阻滞
胸椎旁神经阻滞
乳腺手术
术后镇痛
META分析
serratus anterior plane block
thoracic paravertebral nerve block
breast surgery
postoperative analgesia
Meta-analysis
