摘要
目的评价氢吗啡酮联合罗哌卡因前锯肌平面阻滞(SAPB)在乳腺癌手术术后急性疼痛中的应用效果。方法乳腺癌手术患者58例采用随机数字表法分为氢吗啡酮联合罗哌卡因阻滞组(HR组)和罗哌卡因阻滞组(R组)。两组患者术前行术侧SAPB,记录两组患者术中阿片类药物用量,术后30 min、2 h、4 h、6 h、12 h、24 h和48 h患者数字疼痛分级法(NRS)评分,阻滞相关围手术期指标、术后慢性疼痛发生率。结果与R组比较,HR组患者在术后30 min、2 h、12 h、24 h、48 h静息NRS评分和术后12 h、24 h、48 h运动NRS评分降低(P<0.05),术后12(0 vs.31.0%,P=0.020)、24(27.6%vs.65.5%,P=0.040)、48 h(6.9%vs.37.9%,P=0.005)运动中、重度疼痛发生率降低。HR组患者下床时间较R组更早[20(18,23)h vs.24(20,27)h,P=0.021]。结论氢吗啡酮联合罗哌卡因SAPB可减轻乳腺癌手术术后NRS评分,降低中重度疼痛发生率,缩短患者下床时间。
Objective To evaluate the efficacy of hydromorphone combined with ropivacaine for serratus anterior plane block(SAPB)in acute pain after breast cancer surgery.Methods A total of 58 patients undergoing breast cancer surgery were divided into the hydromorphone combined with ropivacaine block group(group HR)and the Ropivacaine block group(group R)by the random number table method.Before surgery,the patients in the two groups were treated with SAPB.The patients in both groups underwent SAPB before surgery,and the dosage of opioids during surgery,the scores of Numeric Rating Scale(NRS)at 30 min,2 h,4 h,6 h,12 h,24 h and 48 h after surgery,the perioperative indicators related to block and the incidence of chronic pain after surgery were recorded.Results Compared with group R,the resting NRS score at 30 min,2 h,12 h,24 h and 48 h after surgery and exercise NRS score at 12 h,24 h and 48 h after surgery in group HR were decreased(P<0.05),and after 12(0 vs.31.0%,P=0.020),24(27.6%vs.65.5%,P=0.040)and 48 h(6.9%vs.37.9%,P=0.005),the incidence of moderate and severe pain during exercise decreased.The patients in group HR got out of bed earlier than those in group R[20(18,23)h vs.24(20,27)h,P=0.021].Conclusion Hydromorphone combined with ropivacaine SAPB can reduce the NRS score after breast cancer surgery,reduced the incidence of moderate to severe pain,and shorten the time for patients to get out of bed.
作者
王惟
张微
贺轲渝
李巍
WANG Wei;ZHANG Wei;HE Keyu;LI Wei(Department of Anesthesiology,Chongqing University Fuling Hospital,Chongqing 408000,China)
出处
《重庆医学》
CAS
2024年第4期571-575,581,共6页
Chongqing medicine
基金
重庆市涪陵区科技局科研项目(FLKJ,2022AAN1025)。
关键词
前锯肌平面阻滞
乳腺肿瘤
氢吗啡酮
术后疼痛
serratus anterior plane block
breast cancer
hydromorphone
postoperative pain
