Institute of Neuroscience, Basic Medical College, Chongqing Medical University, Chongqing, China.
Department of Cancer Rehabilitation, Winship Cancer Institute, Emory University School of Medicine, 1365 Clifton Rd, Atlanta, GA, 30322, USA.
Support Care Cancer. 2022 Mar;30(3):2787-2792. doi: 10.1007/s00520-021-06696-7. Epub 2021 Nov 27.
Persistent post-mastectomy pain (PPMP) is common after surgery. Although multiple modalities have been used to treat this type of pain, including medications, physical therapy, exercise interventions, cognitive-behavioral psychology, psychosocial interventions, and interventional approaches, managing PPMP may be still a challenge for breast cancer survivors. Currently, serratus plane block (SPB) as a novel regional anesthetic technique shows promising results for controlling chronic pain.
We report four cases of patients with PPMP that were treated using superficial serratus plane block (SSPB) at our clinic. A retrospective review of effect of pain relief was collected through postprocedure interviews.
We found that two of our patients were successfully treated with SSPB for pain after treatment for breast cancer. The third patient had an intercostobrachial nerve block that produced incomplete pain relief but had adequate pain relief with a SSPB. However, the fourth patient reported no pain relief after SSPB.
These cases illustrate that the patients with PPMP could benefit from SSPB. Particularly, we find patients with a subjective sense of "tightness" relating to reconstructive surgeries may be a good candidate for SSPB. Further studies are warranted to evaluate this block for PPMP, as it is low risk and relatively simple to perform.
乳腺癌手术后常出现持续性乳房切除术后疼痛（PPMP）。尽管已经采用了多种方法来治疗这种类型的疼痛，包括药物治疗、物理治疗、运动干预、认知行为心理学、心理社会干预和介入方法，但管理 PPMP 对于乳腺癌幸存者来说可能仍然是一个挑战。目前，胸小肌平面阻滞（SPB）作为一种新的区域麻醉技术，在控制慢性疼痛方面显示出良好的效果。
我们报告了在我们诊所使用浅表胸小肌平面阻滞（SSPB）治疗 4 例 PPMP 患者的情况。通过术后访谈收集了缓解疼痛效果的回顾性评估。
我们发现，我们的 2 例患者在接受乳腺癌治疗后使用 SSPB 成功治疗了疼痛。第 3 例患者行肋间臂神经阻滞，但疼痛缓解不完全，而 SSPB 则产生了足够的疼痛缓解。然而，第 4 例患者报告 SSPB 后无疼痛缓解。
这些病例说明，PPMP 患者可能受益于 SSPB。特别是，我们发现与重建手术相关的主观“紧绷感”的患者可能是 SSPB 的良好候选者。需要进一步的研究来评估这种阻滞方法对 PPMP 的效果，因为它的风险低且相对简单。
