Jin Lian-Jin, Wen Li-Yong, Zhang Yan-Li, Li Gang, Sun Ping, Zhou Xuan
Department of Anesthesia Department of Orthopaedics, The Affiliated Hongqi Hospital of Mudanjiang Medical University Department of Anatomy, Mudanjiang Medical University, Mudanjiang, China.
Medicine (Baltimore). 2017 Sep;96(39):e8107. doi: 10.1097/MD.0000000000008107.
The present study aimed to assess the efficacy and safety of thoracic paravertebral regional anesthesia (TPVBRA) in patients with breast cancer surgery.
In total, 72 patients undergoing breast cancer surgery were randomly divided into an intervention group and a control group; each group contained 36 subjects. Both groups received TPVBRA with 20 mL 0.25% bupivacaine. In addition, subjects in the intervention group also received an additional 1 μg/kg dexmedetomidine. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), pain intensity (measured by visual analogue scale, VAS), and analgesic consumption were assessed; adverse events were also recorded.
Significant differences were observed in HR (P < .05), SBP (P < .05), and DBP (P < .05) at the 30-minute point during surgery between the 2 groups. In addition, the time of the first administration of analgesia (P = .043) and the mean consumption of analgesic agents (P = .035) in the intervention group were much better than those in the control group. However, no significant differences in HR or VAS were found at any time point after surgery (P > .05). Furthermore, similar adverse events were detected in both groups (P > .05).
The results of this study showed that TPVBRA combined with bupivacaine and dexmedetomidine can enhance the duration and quality of analgesia without serious adverse events.
本研究旨在评估胸段椎旁区域麻醉（TPVBRA）在乳腺癌手术患者中的疗效和安全性。
总共72例接受乳腺癌手术的患者被随机分为干预组和对照组；每组包含36名受试者。两组均接受20毫升0.25%布比卡因的TPVBRA。此外，干预组的受试者还额外接受1微克/千克右美托咪定。评估心率（HR）、收缩压（SBP）、舒张压（DBP）、疼痛强度（通过视觉模拟评分法，VAS测量）和镇痛药物消耗量；同时记录不良事件。
两组在手术期间30分钟时的HR（P<0.05）、SBP（P<0.05）和DBP（P<0.05）存在显著差异。此外，干预组首次给予镇痛的时间（P = 0.043）和镇痛药物的平均消耗量（P = 0.035）均明显优于对照组。然而，术后任何时间点的HR或VAS均未发现显著差异（P>0.05）。此外，两组检测到的不良事件相似（P>0.05）。
本研究结果表明，TPVBRA联合布比卡因和右美托咪定可延长镇痛时间并提高镇痛质量，且无严重不良事件。
