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超声引导下Ⅰ型和Ⅱ型胸神经阻滞用于隆乳术后镇痛的效果:一项前瞻性、随机研究。

The efficacy of ultrasound-guided type-I and type-II pectoral nerve blocks for postoperative analgesia after breast augmentation: A prospective, randomised study.

机构信息

Department of Anaesthesiology, Baskent University School of Medicine, Konya, Turkey.

Department of Anaesthesiology, Baskent University School of Medicine, Konya, Turkey.

出版信息

Anaesth Crit Care Pain Med. 2019 Feb;38(1):47-52. doi: 10.1016/j.accpm.2018.03.009. Epub 2018 Apr 5.

Abstract

PURPOSE

The present study was planned to evaluate the efficacy and safety of ultrasound-guided Pecs I and II blocks for postoperative analgesia after sub-pectoral breast augmentation.

METHODS

Fifty-four adult female patients undergoing breast augmentation were randomly divided into two groups: the control group (Group C, n=27) who were not subjected to block treatment and Pecs group (Group P, n=27) who received Pecs I (bupivacain 0.25%, 10mL) and Pecs II (bupivacain 0.25%, 20mL) block. Patient-controlled fentanyl analgesia was used for postoperative pain relief in both groups, and the patients were observed for the presence of any block-related complications.

RESULTS

The 24-h fentanyl consumption was smaller in Group P [mean±SD, 378.7±54.0μg and 115.7±98.1μg, respectively; P<0.001]. VAS scores in Group P were significantly lower at the time of admission to the post-anaesthetic care unit and at 1, 2, 4, 8, 12, and 24h (P<0.001). The rates of nausea and vomiting were higher in Group C than in Group P (9 vs 2, P=0.018). Hospital stay duration was shorter in Group P than in Group C (24.4±1.2h vs 27.0±3.1h, P<0.001). No block-related complications were recorded.

CONCLUSIONS

Combine used of Pecs I and II blocks provide superior postoperative analgesia in patients undergoing breast augmentation and shortens hospital stay.

摘要

目的

本研究旨在评估超声引导下胸肌Ⅰ和Ⅱ阻滞用于胸肌下隆胸术后镇痛的疗效和安全性。

方法

54 例成年女性隆胸患者随机分为两组:对照组(C 组,n=27)未行阻滞治疗和胸肌组(P 组,n=27)接受胸肌Ⅰ(布比卡因 0.25%,10mL)和胸肌Ⅱ(布比卡因 0.25%,20mL)阻滞。两组均采用患者自控芬太尼镇痛,观察有无阻滞相关并发症。

结果

P 组 24 小时芬太尼消耗量较小[(378.7±54.0)μg和(115.7±98.1)μg,P<0.001]。P 组患者在麻醉后恢复室入院时及 1、2、4、8、12、24 小时的 VAS 评分明显较低(P<0.001)。C 组恶心呕吐发生率高于 P 组(9 比 2,P=0.018)。P 组住院时间短于 C 组(24.4±1.2h 比 27.0±3.1h,P<0.001)。未记录到与阻滞相关的并发症。

结论

胸肌Ⅰ和Ⅱ阻滞联合应用可为隆胸患者提供更好的术后镇痛效果,并缩短住院时间。

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