不同容量在超声引导下Ⅰ型胸神经阻滞用于胸下型隆乳术后镇痛的效果：一项前瞻性、随机、对照研究。
The Efficacy of Different Volumes on Ultrasound-Guided Type-I Pectoral Nerve Block for Postoperative Analgesia After Subpectoral Breast Augmentation: A Prospective, Randomized, Controlled Study.
机构信息
Department of Anesthesiology and Reanimation, Istanbul Medipol University, 34000, Bagcilar, Istanbul, Turkey.
Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, 25070, Yakutiye, Erzurum, Turkey.
出版信息
Aesthetic Plast Surg. 2019 Apr;43(2):297-304. doi: 10.1007/s00266-019-01322-8. Epub 2019 Feb 12.
BACKGROUND
PECS type-1 block, a US-guided superficial interfacial block, provides effective analgesia after breast surgery. Aesthetic breast augmentation is one of the most common surgical procedures in plastic surgery. Subpectoral prostheses cause severe pain. The aim of this study was to investigate the effect of different volumes of the solution on the efficacy of PECS type-I block for postoperative analgesia after breast augmentation surgery.
METHODS
Ninety ASA status I-II female patients aged between 18 and 65 years who scheduled breast augmentation surgery under general anesthesia were included in this study. The patients were randomly divided into three groups of 30 patients each (Group 20 = 20 ml of anaesthetic solution, Group 30 = 30 ml anaesthetic solution, and Group K = Control group). Postoperative assessment was performed using the VAS score. The VAS scores were recorded postoperatively at 1, 2, 4, 8, 16 and 24 h.
RESULTS
Fentanyl consumption was statistically significantly lower in Group 20 and Group 30 compared to the Control group (p < 0.05). There was no statistically significant difference in fentanyl consumption between Group 20 and Group 30. The right and left VAS scores were statistically significantly lower in Groups 20 and 30 than in the Control group (p < 0.05). There was no statistical difference in terms of VAS scores between Group 20 and Group 30. The use of rescue analgesia was statistically lower in Groups 20 and 30.
CONCLUSIONS
PECS type-1 block using 20 ml of 0.25% bupivacaine can provide effective analgesia after breast augmentation surgery.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
背景
PECSType-1 阻滞，一种美国引导的浅表界面阻滞，可提供乳房手术后的有效镇痛。美容隆胸是整形手术中最常见的手术之一。胸肌下假体引起严重疼痛。本研究旨在探讨不同容量溶液对 PECSType-I 阻滞用于隆胸手术后镇痛效果的影响。
方法
本研究纳入了 90 名 ASA 分级 I-II 的女性患者，年龄在 18 至 65 岁之间，在全身麻醉下接受隆胸手术。将患者随机分为三组，每组 30 例（组 20=20ml 麻醉溶液，组 30=30ml 麻醉溶液，组 K=对照组）。术后采用视觉模拟评分（VAS）进行评估。术后 1、2、4、8、16 和 24 小时记录 VAS 评分。
结果
与对照组相比，组 20 和组 30 的芬太尼消耗量统计学显著降低（p<0.05）。组 20 和组 30 之间芬太尼消耗量无统计学差异。与对照组相比，组 20 和组 30 的右、左 VAS 评分统计学显著降低（p<0.05）。组 20 和组 30 之间 VAS 评分无统计学差异。组 20 和组 30 的补救性镇痛使用率统计学降低。
结论
在隆胸手术后，使用 20ml0.25%布比卡因的 PECSType-1 阻滞可以提供有效的镇痛。
证据等级 IV：本杂志要求作者为每篇文章分配一个证据等级。有关这些基于证据的医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266 。
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