From the *Department of Anesthesiology, Weill Medical College of Cornell University and New York Presbyterian Hospital; and †Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY.
Reg Anesth Pain Med. 2017 Mar/Apr;42(2):259-262. doi: 10.1097/AAP.0000000000000555.
Postmastectomy pain syndrome (PMPS) is a significant burden for breast cancer survivors. Although multiple therapies have been described, an evolving field of serratus anterior plane blocks has been described in this population. We describe the addition of the deep serratus anterior plane block (DSPB) for PMPS.
Four patients with history of PMPS underwent DSPB for anterior chest wall pain. A retrospective review of these patients' outcomes was obtained through postprocedure interviews.
Three of the patients previously had a superficial serratus anterior plane block, which was not as efficacious as the DSPB. The fourth patient had a superficial serratus anterior plane that was difficult to separate with hydrodissection but had improved pain control with a DSPB.
We illustrate 4 patients who have benefitted from a DSPB and describe indications that this block may be more efficacious than a superficial serratus plane block. Further study is recommended to understand the intercostal nerve branches within the lateral and anterior muscular chest wall planes.
乳腺癌患者术后疼痛综合征（PMPS）是一个严重的负担。尽管已经描述了多种治疗方法，但在前锯肌平面阻滞这一领域仍在不断发展。我们描述了在 PMPS 中添加深层前锯肌平面阻滞（DSPB）。
4 名有 PMPS 病史的患者接受了 DSPB 治疗前胸部疼痛。通过术后访谈获得了这些患者结局的回顾性研究。
其中 3 名患者之前接受过浅层前锯肌平面阻滞，但效果不如 DSPB。第 4 名患者浅层前锯肌平面阻滞效果不佳，但通过 DSPB 可更好地控制疼痛。
我们介绍了 4 名受益于 DSPB 的患者，并描述了该阻滞可能比浅层前锯肌平面阻滞更有效的指征。建议进一步研究以了解侧胸壁和前胸壁肌肉平面内肋间神经分支。
