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超声引导椎旁神经阻滞与中点横突胸膜阻滞在乳腺癌手术中术后镇痛效果的比较:一项随机研究。

The Comparison of Postoperative Analgesic Efficacy of Ultrasound-Guided Paravertebral Block and Mid-Point Transverse Process Pleura Block in Mastectomy Surgeries: A Randomized Study.

机构信息

Department of Anesthesiology and Reanimation, University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum, Türkiye.

Department of Anesthesiology and Reanimation, Faculty of Medicine, Ataturk University, Erzurum, Türkiye.

出版信息

J Invest Surg. 2022 Sep;35(9):1694-1699. doi: 10.1080/08941939.2022.2098544. Epub 2022 Jul 17.

DOI:10.1080/08941939.2022.2098544
PMID:35848451
Abstract

PURPOSE/AIM OF THE STUDY: The purpose of this triple-blind randomized study is to compare the postoperative analgesic efficacy of Mid-Point Transverse Process Pleura Block (MTP) and Paravertebral Block (PVB) in patients undergoing breast surgery.

MATERIALS AND METHODS

The study was retrospectively registered on ClinicalTrials.gov (NCT05332028). A total of 64 patients undergoing unilateral simple mastectomy operation due to breast cancer were included in the study. Before the anesthesia procedure, participants were randomly assigned to one of two groups: Group 1: Participants undergoing PVB or Group 2: Participants undergoing MTP block. All block applications were performed using 20 mL of 0.25% bupivacaine. Routine general anesthesia protocol was performed on all patients. In the postanesthetic care unit, fentanyl infusion was given to all patients postoperatively via a patient-controlled analgesia device. Postoperative fentanyl consumption, time to the first request for analgesia, VAS score values at rest and in motion, and blocked dermatome areas were recorded.

RESULTS

Postoperative total opioid consumption, the number of patients given rescue analgesia, the time requiring postoperative supplemental analgesia, postoperative pain scores at rest and in motion, and blocked dermatome areas at both anterior and posterior lower and upper limits were not different between groups ( > 0.05, for all).

CONCLUSIONS

It was concluded that ultrasound-guided PVB and MTP blocks have similar postoperative analgesic efficacy in patients undergoing breast surgery. The MTP block may be preferred as an alternative to PVB for breast surgeries with less risk of complications.

摘要

研究目的

本三盲随机研究的目的是比较术中经中点横突胸膜阻滞(MTP)与椎旁阻滞(PVB)在乳腺癌患者行乳房手术后的术后镇痛效果。

材料与方法

本研究在 ClinicalTrials.gov 上进行了回顾性注册(NCT05332028)。共纳入 64 例因乳腺癌行单侧单纯乳房切除术的患者。在麻醉前,参与者被随机分配到以下两组中的一组:第 1 组:接受 PVB 的参与者;第 2 组:接受 MTP 阻滞的参与者。所有阻滞应用均采用 20ml 0.25%布比卡因。所有患者均采用常规全身麻醉方案。在麻醉后恢复室,所有患者均通过患者自控镇痛装置给予芬太尼输注。记录术后芬太尼总消耗量、首次请求镇痛的时间、静息和运动时的 VAS 评分值、阻滞的皮区。

结果

两组患者的术后总阿片类药物消耗量、需要解救镇痛的患者人数、需要术后补充镇痛的时间、静息和运动时的术后疼痛评分以及前、后下限的阻滞皮区均无差异( > 0.05,均)。

结论

超声引导下 PVB 和 MTP 阻滞在乳腺癌患者行乳房手术后具有相似的术后镇痛效果。MTP 阻滞可能是乳腺癌手术的一种替代选择,因为其并发症风险较低。

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