Song Wen-Qin, Wang Wei, Yang Ying-Cong, Sun Qian, Chen Hui, Zhang Lei, Bu Xue-Shan, Zhan Li-Ying, Xia Zhong-Yuan
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
J Pain Res. 2020 Apr 30;13:865-871. doi: 10.2147/JPR.S237435. eCollection 2020.
Pectoral nerve block I (PECS I) and serratus-intercostal plane block (SIPB) can anesthetize the majority mammary region, while parasternal intercostal block (PSI) targets the internal area during breast resection surgery. The aim of this study was to determine whether including PSI with PECS I and SIPB is more effective compared to PECS I and SIPB alone.
Sixty-two adult females undergoing unilateral modified radical mastectomy (MRM) were randomly assigned to receive either PECS I and SIPB (PS group, n=31) or a combination of PECS I, SIPB, and PSI (PSP group, n=31). The outcomes were measured with a numerical rating scale (NRS) score, and in terms of opioid consumption and anesthesia-related complications within 48 h after surgery.
Although there were no differences in the NRS scores between the two groups during the inactive periods, the combination of three nerve blocks significantly reduced the NRS scores during movement. In addition, morphine equivalent consumption was lower in the PSP group compared to the PS group. Postoperative adverse events were similar in both groups in terms of regional anesthesia-related complications.
The combination of PECS I block, SIPB, and PSI block provides superior pain relief and postoperative recovery for patients undergoing MRM.
胸肌神经阻滞I（PECS I）和前锯肌-肋间平面阻滞（SIPB）可麻醉大部分乳腺区域，而胸骨旁肋间阻滞（PSI）在乳腺切除手术中针对内部区域。本研究的目的是确定与单独的PECS I和SIPB相比，将PSI与PECS I和SIPB联合使用是否更有效。
62例行单侧改良根治性乳房切除术（MRM）的成年女性被随机分配接受PECS I和SIPB（PS组，n = 31）或PECS I、SIPB和PSI联合治疗（PSP组，n = 31）。采用数字评分量表（NRS）评分以及术后48小时内的阿片类药物消耗量和麻醉相关并发症来衡量结果。
尽管在非活动期两组的NRS评分没有差异，但三种神经阻滞联合使用在活动期间显著降低了NRS评分。此外，PSP组的吗啡当量消耗量低于PS组。两组在区域麻醉相关并发症方面的术后不良事件相似。
PECS I阻滞、SIPB和PSI阻滞联合使用为接受MRM的患者提供了更好的疼痛缓解和术后恢复效果。
