Department of Anesthesiology, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing, People's Republic of China.
Department of Paediatrics, Affiliated Hospital of Guilin Medical University, Guilin, People's Republic of China.
Clin Interv Aging. 2020 Jun 22;15:937-944. doi: 10.2147/CIA.S251613. eCollection 2020.
Pectoral nerve block type I (PECS I Block) and type II (PECS II Block) with ropivacaine are relatively new analgesic methods for breast-cancer surgery. We evaluated the safety and efficacy of different concentrations of ropivacaine given in the same volume for the PECS II Block in patients undergoing modified radical mastectomy (MRM).
One hundred and twenty women undergoing elective MRM who met inclusion criteria were divided randomly into four groups of 30: control group without PECS II Block and R, R, and R groups, who received general anesthesia plus the PECS II Block with ropivacaine at 0.2%, 0.3%, and 0.4%, respectively, in a volume of 40 mL.
The postoperative numerical rating scale (NRS) pain score at rest and active was significantly higher in the control group than that in the three ropivacaine groups (P<0.05 for all), and the postoperative NRS score in the R group and R group at 12, 24, and 48 h postoperatively were significantly lower than that in the R group (P<0.05 for all); there was no significant difference between the R group and R group. The time when pain was first felt after MRM, the total number of complaints during 3, 6, 12, 24, and 48 h after MRM, and the total analgesic requirement (tramadol consumption) during the first 24 h postoperatively in the R group and R group were significantly lower than those in the control group and R group (P<0.05 for all); there was no significant difference between the R group and R group.
A dose of 0.3% ropivacaine was the optimal concentration for a PECS II Block for patients undergoing MRM because it provided efficacious analgesia during and >48 h after MRM. Increasing the ropivacaine concentration did not improve the analgesia of the PECS II Block significantly.
胸长神经阻滞（PECS I 阻滞和 PECS II 阻滞）联合罗哌卡因在乳腺癌手术中是一种相对较新的镇痛方法。我们评估了相同容量下不同浓度的罗哌卡因用于改良根治性乳房切除术（MRM）患者的 PECS II 阻滞的安全性和有效性。
120 名符合纳入标准的择期行 MRM 的女性患者被随机分为四组，每组 30 例：无 PECS II 阻滞的对照组和 R、R 和 R 组，分别接受全身麻醉加 PECS II 阻滞，罗哌卡因浓度分别为 0.2%、0.3%和 0.4%，容量为 40mL。
与三组罗哌卡因组相比，对照组术后静息和活动时数字评分量表（NRS）疼痛评分明显较高（所有 P<0.05），R 组和 R 组术后 12、24 和 48 h 的 NRS 评分明显低于 R 组（所有 P<0.05）；R 组和 R 组之间无显著差异。MRM 后首次感到疼痛的时间、MRM 后 3、6、12、24 和 48 h 内总投诉次数、MRM 后 24 h 内总镇痛需求（曲马多消耗量）在 R 组和 R 组均明显低于对照组和 R 组（所有 P<0.05）；R 组和 R 组之间无显著差异。
对于行 MRM 的患者，0.3%罗哌卡因剂量是 PECS II 阻滞的最佳浓度，因为它在 MRM 期间和 MRM 后>48 h 提供了有效的镇痛。增加罗哌卡因浓度并不能显著改善 PECS II 阻滞的镇痛效果。
