Kang Chang Min, Kim Woo Jeong, Yoon Sean Hyuck, Cho Chul Bum, Shim Jeong Su
Department of Plastic and Reconstructive Surgery, School of Medicine, Catholic University of Daegu, Duryugongwon-ro 17-gil, Nam-gu, Daegu, 705-718, Republic of Korea.
V-plastic Surgery, Daegu, Republic of Korea.
Aesthetic Plast Surg. 2017 Oct;41(5):1031-1036. doi: 10.1007/s00266-017-0802-6. Epub 2017 Aug 8.
In breast augmentation with implant, there is severe pain due to damage from expansion of breast tissue and the pectoralis major. Therefore, the authors conducted this study to analyze the effectiveness of postoperative intercostal nerve block (ICNB) in reducing postoperative pain after breast augmentation with implant.
Forty-four female patients were enrolled in the study. Just before awaking from general anesthesia, 34 cases were injected with 0.2% ropivacaine to both third, fourth, fifth, and sixth intercostal spaces. We compared them (ICNB group) with the control group for VAS scores at the time of arrival in the recovery room, after 30, 60, and 120 min.
The average VAS scores per time of the control group and ICNB group were 7.1 ± 0.74 and 3.50 ± 1.81 at arrival time in the recovery room, 7.00 ± 0.67 and 3.03 ± 1.47 after 30 min, 5.50 ± 0.71 and 2.68 ± 1.49 after 60 min, and 4.60 ± 0.84 and 2.00 ± 1.35 after 120 min. VAS scores of two groups were significantly different at each time and decreased overall. Also, time and group effect of the two groups were significantly different, especially between 30 and 60 min.
ICNB just before awaking from general anesthesia showed a statistically significant reduction in VAS score, and this means postoperative pain was reduced effectively and time to discharge could be shortened. Therefore, it can be a good way to reduce postoperative pain after augmentation mammoplasty with implant.
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在植入式隆胸手术中，由于乳腺组织和胸大肌扩张造成的损伤会引起剧烈疼痛。因此，作者开展了本研究，以分析术后肋间神经阻滞（ICNB）在减轻植入式隆胸术后疼痛方面的有效性。
44名女性患者纳入本研究。在全身麻醉即将苏醒前，对34例患者的第三、第四、第五和第六肋间间隙注射0.2%罗哌卡因。我们将她们（ICNB组）与对照组在进入恢复室时、30、60和120分钟后的视觉模拟评分（VAS）进行比较。
对照组和ICNB组在进入恢复室时的平均每次VAS评分为7.1±0.74和3.50±1.81，30分钟后为7.00±0.67和3.03±1.47，60分钟后为5.50±0.71和2.68±1.49，120分钟后为4.60±0.84和2.00±1.35。两组在各时间点的VAS评分均有显著差异，且总体呈下降趋势。此外，两组的时间和组间效应有显著差异，尤其是在30至60分钟之间。
全身麻醉即将苏醒前进行ICNB显示VAS评分有统计学意义的降低，这意味着术后疼痛得到有效减轻，出院时间可以缩短。因此，它可能是减轻植入式隆胸术后疼痛的一种好方法。
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