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超声引导下胸大肌神经阻滞在隆乳术后镇痛中的应用:一项随机临床研究。

Ultrasound-guided pectoral nerve block for pain control after breast augmentation: a randomized clinical study.

机构信息

Istanbul Medipol University, Department of Anesthesiology and Reanimation, Istanbul, Turkey.

Istanbul Medipol University, Department of Anesthesiology and Reanimation, Istanbul, Turkey.

出版信息

Braz J Anesthesiol. 2021 Jan-Feb;71(1):44-49. doi: 10.1016/j.bjane.2020.12.004. Epub 2020 Dec 25.

Abstract

BACKGROUND AND OBJECTIVE

Pectoral nNerve (PECS) block type-1 is an Ultrasound (US)-guided interfacial block that can be performed for postoperative analgesia management after breast surgery. In the procedure, a local anesthetic solution is injected into the interfacial area between the Pectoralis Major muscles (PMm) and Pectoralis minor muscles (Pmm). The present study compared PECS block type-1 administered preoperatively or postoperatively for postoperative analgesia after breast augmentation surgery.

METHODS

The patients were randomly divided into three groups (n = 30 in each): a preoperative PECS block group (Pregroup), postoperative PECS block group (Postgroup), and control group (Group C). Opioid consumption and Visual Analogue Scale (VAS) scores were evaluated at postoperative period.

RESULTS

The pains scores in the Pregroup were significantly lower than those in the control group. Although there was no significantly difference in the VAS scores of the Postgroup and control group at postoperative 1 hour, the scores in the Postgroup were significantly lower than those in the control group at all the other evaluated times (p < 0.05). The VAS scores in the Pregroup were significantly lower than those in the Postgroup 8 hours after the surgery. Opioid consumption was significantly lower in the Pregroup as compared with that in the other two groups (p < 0.05). The use of rescue analgesia in the Pregroup was significantly lower than that in the other groups (p < 0.05).

CONCLUSION

Performing PECS block type-1 preoperatively reduced VAS scores and opioid consumption after breast augmentation.

摘要

背景与目的

胸大肌皮神经(PECS)阻滞 1 型是一种超声(US)引导下的界面阻滞,可用于乳房手术后的术后镇痛管理。在该过程中,将局部麻醉溶液注入胸大肌(PMm)和胸小肌(Pmm)之间的界面区域。本研究比较了乳房增大手术后行预防性或术后 PECS 阻滞 1 型对术后镇痛的效果。

方法

患者被随机分为三组(每组 n=30):术前 PECS 阻滞组(Pregroup)、术后 PECS 阻滞组(Postgroup)和对照组(Group C)。在术后期间评估阿片类药物的消耗量和视觉模拟评分(VAS)。

结果

Pregroup 的疼痛评分明显低于对照组。尽管术后 1 小时时,Postgroup 与对照组的 VAS 评分之间没有显著差异,但在所有其他评估时间点,Postgroup 的评分均明显低于对照组(p<0.05)。手术后 8 小时,Pregroup 的 VAS 评分明显低于 Postgroup。与其他两组相比,Pregroup 的阿片类药物消耗量明显较低(p<0.05)。与其他两组相比,Pregroup 对解救性镇痛的需求明显较低(p<0.05)。

结论

行预防性 PECS 阻滞 1 型可降低乳房增大术后的 VAS 评分和阿片类药物的消耗量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecbd/9373212/165b0c6442ac/gr1.jpg

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