Pérez Herrero M A, López Álvarez S, Fadrique Fuentes A, Manzano Lorefice F, Bartolomé Bartolomé C, González de Zárate J
Hospital Clínico Universitario de Valladolid, Valladolid, España.
Complejo Hospitalario Universitario de A Coruña, A Coruña, España.
Rev Esp Anestesiol Reanim. 2016 Dec;63(10):564-571. doi: 10.1016/j.redar.2016.03.006. Epub 2016 Apr 16.
The quality of postoperative recovery is one of the most important among all the quality indicators used in clinical situations. This is even more important after cancer surgery. Our aim was to evaluate this after non-reconstructive breast surgery under general anesthesia and paravertebral blockade or serratus-intercostal plane blockade, in the early and late post-operative period.
A prospective observational study was conducted on 60 patients (25 paravertebral blockade group and 35 serratus-intercostal plane blockade group) scheduled for non-reconstructive breast surgery during a 6 month period. Every patient received general anaesthesia and were randomised to receive either paravertebral blockade or serratus-intercostal plane blockade. The quality of post-anaesthetic recovery was quantified by Postoperative Quality Recovery Scale, which is used to assess physiological, nociceptive, emotional, autonomy, cognitive and general state domains at different times: baseline (before surgery), 15min after the end of surgery, at discharge to home, and one month after surgery.
A total recovery of 95.93% was achieved in the early postoperative period (15min PACU), 99.07% at discharge to home, and 99.25% at one month after the intervention. No significant differences were found between groups in total score or in each evaluated area.
A progressive improvement was observed in the scores assessed with the Postoperative Quality Recovery Scale, reaching values that would allow the discharge to home and early return to usual active life from the immediate postoperative period, with no significant differences between the 2 analgesic techniques. Savings in opioid use and the excellent recovery were observed in all measured domains observed.
术后恢复质量是临床应用的所有质量指标中最重要的指标之一。这在癌症手术后更为重要。我们的目的是在全身麻醉联合椎旁阻滞或前锯肌-肋间平面阻滞下进行非重建性乳房手术后的早期和晚期，评估术后恢复质量。
对60例计划在6个月内进行非重建性乳房手术的患者进行了一项前瞻性观察研究（25例椎旁阻滞组和35例前锯肌-肋间平面阻滞组）。每位患者均接受全身麻醉，并随机接受椎旁阻滞或前锯肌-肋间平面阻滞。麻醉后恢复质量通过术后质量恢复量表进行量化，该量表用于评估不同时间的生理、伤害感受、情绪、自主性、认知和一般状态领域：基线（手术前）、手术结束后15分钟、出院回家时以及手术后1个月。
术后早期（PACU 15分钟）总恢复率为95.93%，出院回家时为99.07%，干预后1个月为99.25%。两组在总分或每个评估区域均未发现显著差异。
使用术后质量恢复量表评估的分数有逐步改善，达到了允许患者出院回家并从术后即刻早期恢复正常积极生活的值，两种镇痛技术之间无显著差异。在所有测量领域均观察到阿片类药物使用量的节省和出色的恢复情况。
