Zhang Ziying, Li Zhengyao, Zhang Zixuan, Guan Xiaoyu, Xin Minqiang
Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100144, China.
Aesthetic Plast Surg. 2023 Feb;47(1):106-115. doi: 10.1007/s00266-022-03135-8. Epub 2022 Oct 26.
To evaluate the analgesic effect of pectoral nerve block in implant-based mammoplasty.
EMbase, PubMed, Web of science, MEDLINE, CNKI, Wanfang Database, VIP and other databases were searched from establishment to February 2022 by computer to collect randomized controlled trials which applied pectoral nerve block in implant-based mammoplasty, and meta-analysis was conducted after data extraction and quality evaluation of the literature meeting the inclusion criteria.
A total of 336 patients in seven RCT studies were included in this study. Pectoral nerve block has a significant effect on postoperative analgesia in patients with implant-based mammoplasty with 1h VAS score significantly reduced in the resting state (MD=-1.85, 95%CI: -2.64-1.07, P<0.00001); VAS score was significantly decreased 4-6 hours after operation (MD=-1.51, 95%CI: -2.47-0.55, P=0.002); postoperative opioid consumption was reduced (SMD=-1.37, 95%CI: -2.51~-0.24, P=0.02) in PECS block group; and the incidence of postoperative nausea and vomiting in the PECS block group was significantly lower (RR: 0.30, 95 %CI: 0.19-0.38, P<0.00001).
The application of PECS block in submuscular implant-based mammoplasty can effectively reduce the degree of acute postoperative pain, opioid consumption and the incidence of postoperative nausea and vomiting, indicating its broad prospects in clinical application.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
评估胸神经阻滞在假体隆乳术中的镇痛效果。
通过计算机检索EMbase、PubMed、Web of science、MEDLINE、CNKI、万方数据库、维普等数据库,检索时间从建库至2022年2月,收集在假体隆乳术中应用胸神经阻滞的随机对照试验,对符合纳入标准的文献进行数据提取和质量评价后进行Meta分析。
本研究共纳入7项随机对照试验中的336例患者。胸神经阻滞对假体隆乳术患者术后镇痛效果显著,静息状态下1小时视觉模拟评分(VAS)显著降低(MD=-1.85,95%CI:-2.64-1.07,P<0.00001);术后4-6小时VAS评分显著降低(MD=-1.51,95%CI:-2.47-0.55,P=0.002);胸肌平面阻滞(PECS)组术后阿片类药物用量减少(SMD=-1.37,95%CI:-2.51~-0.24,P=0.02);PECS阻滞组术后恶心呕吐发生率显著降低(RR:0.30,95%CI:0.19-0.38,P<0.00001)。
PECS阻滞在胸肌下假体隆乳术中的应用可有效减轻术后急性疼痛程度、减少阿片类药物用量及术后恶心呕吐的发生率,表明其在临床应用中具有广阔前景。
证据级别III:本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266 。