单独使用锯肌平面阻滞与联合胸肌1型阻滞用于乳腺癌手术的比较：一项随机对照研究。

Comparison of serratus plane block alone and in combination with pectoral type 1 block for breast cancer surgery: a randomized controlled study.

作者信息

Yesiltas S, Türköz A, Çalım M, Yılmaz S, Esen A, Daşkaya H, Karaaslan K

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.

出版信息

Hippokratia. 2021 Jan-Mar;25(1):8-14.

PMID:35221650

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8877920/

Abstract

BACKGROUND/AIM: Concurrent application of ultrasound-guided pectoral type 1 (PECS I) and serratus plane block (SPB) is one of the most appropriate multimodal analgesic strategies for reducing acute post-mastectomy pain. The purpose of the present study was to compare the analgesic efficacy of SPB alone, or in combination with PECS I block for post-mastectomy pain following breast cancer surgery.

MATERIALS AND METHODS

Sixty participants undergoing breast cancer surgery were randomly assigned to two groups. After anesthesia induction, group S (n =30) received SPB alone, whereas the SPECS group (n =30) received a combination of PECS I and SPB. Pain scores at 0, 1, 2, 6, 12, 24 h postoperatively, intra-operative fentanyl consumption, postoperative time to first rescue analgesia, nausea, vomiting, patient satisfaction, and anesthesia-related complications were recorded.

RESULTS

Pain scores in the SPECS group were significantly lower than group S throughout the follow-up period (p <0.001). A significant reduction in postoperative rescue morphine consumption (p =0.01, median difference 7 mg, 95 % confidence interval: 5.1-7.9 mg) and intraoperative fentanyl consumption (p =0.01) in the SPECS group compared with group S. Moreover, postoperative nausea and vomiting were lower, and patient satisfaction was higher in the SPECS group compared with that of the group S.

CONCLUSIONS

These results suggest that SPB application and PECS I provide more effective and reliable perioperative analgesia and increase patient satisfaction in breast cancer surgery. HIPPOKRATIA 2021, 25 (1):8-14.

TRIAL REGISTRATION NUMBER

NCT03899545.

摘要

背景/目的：超声引导下胸肌1型（PECS I）阻滞与锯肌平面阻滞（SPB）联合应用是减轻乳房切除术后急性疼痛的最合适的多模式镇痛策略之一。本研究的目的是比较单独使用SPB或联合PECS I阻滞对乳腺癌手术后乳房切除术后疼痛的镇痛效果。

材料与方法

60例接受乳腺癌手术的参与者被随机分为两组。麻醉诱导后，S组（n = 30）仅接受SPB，而SPECS组（n = 30）接受PECS I和SPB联合阻滞。记录术后0、1、2、6、12、24小时的疼痛评分、术中芬太尼用量、术后首次补救镇痛时间、恶心、呕吐、患者满意度和麻醉相关并发症。

结果

在整个随访期间，SPECS组的疼痛评分显著低于S组（p < 0.001）。与S组相比，SPECS组术后补救吗啡用量（p = 0.01，中位数差异7 mg，95%置信区间：5.1 - 7.9 mg）和术中芬太尼用量（p = 0.01）显著降低。此外，与S组相比，SPECS组术后恶心和呕吐发生率更低，患者满意度更高。