全身麻醉联合胸椎旁神经阻滞用于改良根治性乳房切除术
General anesthesia with thoracic paravertebral block for modified radical mastectomy.
作者信息
Arunakul Preeyaphan, Ruksa Acksara
机构信息
Department of Anesthesia, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
出版信息
J Med Assoc Thai. 2010 Dec;93 Suppl 7:S149-53.
OBJECTIVE
To evaluate the effect of single-injection paravertebral block (PVB) combined with general anesthesia on 24-hour postoperative morphine requirement in patients undergoing modified radical mastectomy (MRM).
MATERIAL AND METHOD
20 patients were randomly assigned into 2 groups. Patients in the control group were given only general anesthesia. Patients in the PVB group received 0.3 ml/kg of 0.5% plain bupivacaine at T4 paravertebral space followed by general anesthesia. Both groups received intravenous morphine patient-controlled analgesia (PCA) device postoperatively. All patients were evaluated at 1 and 24 hours for pain, nausea and vomiting. Twenty-four hour morphine consumption, antiemetics requirement, and overall satisfaction were recorded.
RESULTS
Patients with PVB had lower incidence and severity of postoperative pain, nausea and vomiting and other serious complications. No patients were unsatisfied with anesthetic techniques.
CONCLUSION
PVB can reduce postoperative opioid requirement, pain, and severity of nausea and vomiting in MRM.
目的
评估单次椎旁阻滞（PVB）联合全身麻醉对改良根治性乳房切除术（MRM）患者术后24小时吗啡需求量的影响。
材料与方法
20例患者随机分为2组。对照组患者仅接受全身麻醉。PVB组患者在T4椎旁间隙注射0.3 ml/kg的0.5%布比卡因原液，随后接受全身麻醉。两组术后均使用静脉吗啡患者自控镇痛（PCA）装置。所有患者在术后1小时和24小时评估疼痛、恶心和呕吐情况。记录24小时吗啡消耗量、止吐药需求量和总体满意度。
结果
接受PVB的患者术后疼痛、恶心和呕吐及其他严重并发症的发生率和严重程度较低。没有患者对麻醉技术不满意。
结论
PVB可降低MRM患者术后阿片类药物需求量、疼痛以及恶心和呕吐的严重程度。
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