Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, 061014, China.
Cell Mol Biol (Noisy-le-grand). 2022 Jan 2;67(4):264-273. doi: 10.14715/cmb/2021.67.4.29.
This study aimed to investigate the clinical effect of ultrasound-guided ropivacaine combined with butorphanol continuous paravertebral block in preventing postoperative pain syndrome of breast cancer. For this purpose, 100 women treated for breast cancer from April 2018 to July 2019 were enrolled as research objects. Surgical procedures included local sentinel lymph node biopsy, mastectomy, sentinel lymph node biopsy for mastectomy, modified radical mastectomy, and implantation. The selected patients were randomly divided into two groups: control group (routine operation anesthesia; n = 50) and observation group (ultrasound-guided thoracic paravertebral block before induction of ropivacaine+butorphanol anesthesia; n = 50). The Real-time PCR technique was performed to evaluate CCL2 gene expression. VAS scores were recorded during the postoperative period. Compared with the control group, the observation group had lower VAS scores at six h, 24h, and 48h (P<0.05). The pain effect of the observation group was less than that of the control group. The observation group had better analgesic effects after anesthesia. The observation group had a lower incidence of pain syndrome at the 6th, 8th, and 12th months (P<0.05), and the incidence of pain syndrome in the two groups decreased with the extension of time. The observation group had lower levels of related factors (P<0.05), and the observation group had lower traumatic stress responses. The protein expression of IL-6, IL-17, and CRP in the observation group was lower than that in the control group (P<0.05). The results of CCL2 gene expression also showed that gene expression in the control group increased significantly (P=0.0047). Since the expression of this gene is one of the factors that stimulate pain signals in the body, the method used in the present study was able to reduce the amount of pain significantly. Therefore, the combination of ropivacaine combined with butorphanol ultrasound-assisted paravertebral block can reduce the intensity of postoperative pain in patients with breast cancer surgery, decrease the incidence of pain syndrome, and increase pain tolerance.
本研究旨在探讨超声引导下罗哌卡因联合布托啡诺连续椎旁阻滞预防乳腺癌术后疼痛综合征的临床效果。为此,纳入了 2018 年 4 月至 2019 年 7 月期间接受乳腺癌治疗的 100 名女性作为研究对象。手术程序包括局部前哨淋巴结活检、乳房切除术、乳房切除术的前哨淋巴结活检、改良根治性乳房切除术和植入术。选择的患者被随机分为两组:对照组(常规手术麻醉;n = 50)和观察组(诱导罗哌卡因麻醉前超声引导胸椎旁阻滞+布托啡诺麻醉;n = 50)。采用实时 PCR 技术评估 CCL2 基因表达。记录术后期间的 VAS 评分。与对照组相比,观察组在术后 6 小时、24 小时和 48 小时时的 VAS 评分较低(P<0.05)。观察组的疼痛效果小于对照组。观察组麻醉后的镇痛效果更好。观察组在第 6、8 和 12 个月时疼痛综合征的发生率较低(P<0.05),且两组的疼痛综合征发生率随时间的延长而降低。观察组相关因素水平较低(P<0.05),观察组创伤应激反应较低。观察组的 IL-6、IL-17 和 CRP 蛋白表达低于对照组(P<0.05)。CCL2 基因表达的结果也表明,对照组的基因表达显著增加(P=0.0047)。由于该基因的表达是刺激体内疼痛信号的因素之一,因此本研究中使用的方法能够显著减轻疼痛程度。因此,罗哌卡因联合布托啡诺超声辅助椎旁阻滞可降低乳腺癌手术患者术后疼痛强度,降低疼痛综合征发生率,提高疼痛耐受力。