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超声引导下改良胸肌Ⅱ型神经阻滞中不同容量 0.3%罗哌卡因对乳腺癌改良根治术患者镇痛和应激反应的影响:一项前瞻性平行随机双盲对照临床试验。

Analgesia and stress attenuation of ultrasound-guided modified pectoral nerve block type-II with different volumes of 0.3% ropivacaine in patients undergoing modified radical mastectomy for breast cancer: A prospective parallel randomized double-blind controlled clinical trial.

机构信息

Department of Anesthesiology, Affiliated Hospital of Putian College, Putian, Fujian, China.

Department of Anesthesiology, Putian Maternity and Child Care Hospital, Putian, Fujian, China.

出版信息

J Clin Pharm Ther. 2022 Oct;47(10):1676-1683. doi: 10.1111/jcpt.13720. Epub 2022 Jun 28.

Abstract

WHAT IS KNOWN AND OBJECTIVE

A previous randomized clinical trial concluded that an optimal concentration of 0.3% ropivacaine could provide satisfactory analgesia for breast cancer patients undergoing modified radical mastectomy. We wondered if a smaller volume (30 ml vs. 40 ml) of 0.3% ropivacaine could still provide adequate analgesia in an ultrasound-guided PECS II block in modified radical mastectomy.

METHODS

We performed a prospective parallel randomized double-blind controlled clinical trial. Eligible patients were assigned to either the P or P group (30 or 40 ml of 0.3% ropivacaine, respectively). The skin area of hypoesthesia, anaesthetic plane determined with ultrasound, pain visual analogue scale (VAS), anaesthetic dosages, and complications were recorded. Serum levels of interleukin-1β and interleukin-6 were measured postoperatively.

RESULTS AND DISCUSSION

A total of 40 patients completed the trials, with 20 patients in each group. Although the skin area of hypoesthesia and the anaesthetic planes were significantly larger in the P group compared with the P group (p < 0.05), the VAS, analgesic and opioid doses, serum cytokine levels, anaesthetic toxicity, and complications had no significant differences between the two groups.

WHAT IS NEW AND CONCLUSION

Compared with 40 ml, 30 ml of 0.3% ropivacaine could provide adequate analgesia and reduce surgical stress in patients undergoing modified radical mastectomy for breast cancer.

摘要

已知和目的

先前的一项随机临床试验得出结论,0.3%罗哌卡因的最佳浓度可为接受改良根治性乳房切除术的乳腺癌患者提供满意的镇痛效果。我们想知道,在超声引导下的 PECS II 阻滞中,较小剂量(30ml 比 40ml)的 0.3%罗哌卡因是否仍能提供足够的镇痛效果。

方法

我们进行了一项前瞻性平行随机双盲对照临床试验。符合条件的患者被分配到 P 组或 P 组(分别给予 30 或 40ml 的 0.3%罗哌卡因)。记录皮肤感觉减退区、超声确定的麻醉平面、疼痛视觉模拟评分(VAS)、麻醉剂量和并发症。术后测量血清白细胞介素-1β和白细胞介素-6水平。

结果与讨论

共有 40 名患者完成了试验,每组 20 名。尽管 P 组的皮肤感觉减退区和麻醉平面明显大于 P 组(p<0.05),但 VAS、镇痛和阿片类药物剂量、血清细胞因子水平、麻醉毒性和并发症在两组之间无显著差异。

新发现和结论

与 40ml 相比,30ml 的 0.3%罗哌卡因可为接受乳腺癌改良根治性乳房切除术的患者提供足够的镇痛效果,并减轻手术应激。

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