Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
Department of Anesthesiology and Reanimation, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
J Clin Anesth. 2022 Aug;79:110691. doi: 10.1016/j.jclinane.2022.110691. Epub 2022 Feb 25.
Breast cancer is quite common in women, and surgery is the most effective treatment in most cases. This study compared the effects of ultrasound (US)-guided erector spinae plane block (ESPB) and pectoserratus plane block (PSPB) on the postoperative opioid consumption and acute and chronic pain in patients after breast cancer surgery.
Prospective, randomized, single-blind.
University hospital.
This study included 90 patients (ASA I-II) who underwent segmental mastectomy and sentinel lymph node biopsy at the hospital of Ondokuz Mayis University, Samsun.
The patients were divided into the ESPB group, PSPB group, and control group. Intraoperatively, all patients were administered intravenous tenoxicam (20 mg) and paracetamol (1 g) as part of multimodal analgesia. Intravenous morphine via patient-controlled analgesia was administered in all groups postoperatively.
The primary outcome was the total morphine consumption in the first 24 h after surgery. The secondary outcomes included visual analog scale pain scores of the arm at rest and at abduction in the first 24 h and at 3 months postoperatively, intraoperative remifentanil consumption, number of patients requesting rescue analgesia, incidence of nausea and vomiting, time to the first request for analgesia via patient-controlled analgesia.
Postoperative 24-h morphine consumption, visual analog scale scores at rest and at abduction, and intraoperative remifentanil consumption were lower in the ESPB and PSPB groups than in the control group. Time to the first request for analgesia via patient controlled analgesia was longer in the ESPB and PSPB groups than in the control group. In the PSPB group, none of the patients needed rescue analgesia.
US-guided ESPB and PSPB performed in patients who underwent breast cancer surgery showed similar and modest analgesic effects on the postoperative opioid consumption and acute and chronic pain scores.
乳腺癌在女性中较为常见，在大多数情况下，手术是最有效的治疗方法。本研究比较了超声引导竖脊肌平面阻滞（ESPB）和胸小肌平面阻滞（PSPB）对乳腺癌手术后患者术后阿片类药物消耗以及急性和慢性疼痛的影响。
前瞻性、随机、单盲。
大学医院。
本研究纳入了 90 例在奥兹多库兹梅伊斯大学萨姆松分校医院接受节段性乳房切除术和前哨淋巴结活检的患者（ASA I-II 级）。
患者分为 ESPB 组、PSPB 组和对照组。术中所有患者均接受静脉注射替诺昔康（20mg）和扑热息痛（1g）作为多模式镇痛的一部分。所有患者术后均接受静脉注射吗啡自控镇痛。
主要结局是术后 24 小时内的总吗啡消耗量。次要结局包括术后 24 小时和 3 个月时手臂静息和外展时的视觉模拟评分（VAS）疼痛评分、术中瑞芬太尼消耗、需要解救镇痛的患者人数、恶心呕吐发生率、首次通过患者自控镇痛请求镇痛的时间。
与对照组相比，ESPB 组和 PSPB 组术后 24 小时吗啡消耗量、静息和外展时的 VAS 评分以及术中瑞芬太尼消耗量较低。ESPB 组和 PSPB 组首次通过患者自控镇痛请求镇痛的时间较长。在 PSPB 组，无患者需要解救镇痛。
在接受乳腺癌手术的患者中进行超声引导的 ESPB 和 PSPB 可产生类似且适度的镇痛效果，对术后阿片类药物消耗以及急性和慢性疼痛评分有影响。
