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术后前锯肌平面阻滞对乳腺癌手术患者术后镇痛的影响。

The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery.

作者信息

Aslan Gökhan, Avcı Onur, Gündoğdu Oğuz, İsbir Ahmet Cemil, Özdemir Kol İclal, Kaygusuz Kenan, Gürsoy Sinan

机构信息

Department of Anesthesiology and Reanimation, Cumhuriyet University School of Medicine, Sivas, Turkey.

Clinic of Anesthesiology and Reanimation, Numune Hospital, Sivas, Turkey.

出版信息

Turk J Surg. 2020 Dec 29;36(4):374-381. doi: 10.47717/turkjsurg.2020.4744. eCollection 2020 Dec.

Abstract

OBJECTIVES

This study aimed to evaluate the effect of serratus anterior plane block (SAP) on postoperative morphine consumption. We aimed to determine the differences between both similar blocks and evaluate the effect of the methods of application of this block on patients' postoperative pain scores and morphine consumption.

MATERIAL AND METHODS

This study is a single-center, prospective and observational study performed with 40 volunteer patients with American Society of Anesthesiologists (ASA) I-III, who were 18-70 years of age, scheduled for breast surgery. A total of 40 patients who underwent general anesthesia were divided into two groups each with 20 patients. While SAP block was applied to the study group, no block was applied to the control group. SAP block was made by injecting a total of 40 ml of 0.25% bupivacaine between 2 muscles after the test dose was injected with saline. All patients were followed up for 12 hours postoperatively with patient-controlled analgesia (PCA) pump. Morphine consumption, visual analogue score (VAS) values and side effects were recorded at the postoperative 1st, 6th and 12th hours.

RESULTS

There was no significant difference between the two groups in terms of hemodynamic parameters and demographic data. Postoperative morphine consumption and postoperative analgesic requirement were significantly lower in the SAP block group (p <0.001). Postoperative VAS values were significantly lower in the SAP block group (p <0.001). No complication was observed related to the block.

CONCLUSION

It was found that the SAP block reduced morphine consumption, significantly decreased VAS values, and reduced side effects due to opioids postoperatively.

摘要

目的

本研究旨在评估前锯肌平面阻滞(SAP)对术后吗啡用量的影响。我们旨在确定两种相似阻滞之间的差异,并评估该阻滞的应用方法对患者术后疼痛评分和吗啡用量的影响。

材料与方法

本研究是一项单中心、前瞻性观察性研究,对40例年龄在18 - 70岁、美国麻醉医师协会(ASA)分级为I - III级、计划行乳腺手术的志愿者患者进行。总共40例接受全身麻醉的患者被分为两组,每组20例。研究组接受SAP阻滞,对照组不进行阻滞。在注射生理盐水试验剂量后,于两块肌肉之间注射总共40 ml的0.25%布比卡因进行SAP阻滞。所有患者术后使用患者自控镇痛(PCA)泵随访12小时。记录术后第1、6和12小时的吗啡用量、视觉模拟评分(VAS)值及副作用。

结果

两组在血流动力学参数和人口统计学数据方面无显著差异。SAP阻滞组术后吗啡用量和术后镇痛需求显著更低(p <0.001)。SAP阻滞组术后VAS值显著更低(p <0.001)。未观察到与阻滞相关的并发症。

结论

发现SAP阻滞减少了吗啡用量,显著降低了VAS值,并减少了术后阿片类药物引起的副作用。

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Injection Volume and Anesthetic Effect in Serratus Plane Block.肋间神经从阻滞的注射容量与麻醉效果。
Reg Anesth Pain Med. 2017 Nov/Dec;42(6):737-740. doi: 10.1097/AAP.0000000000000649.

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