Chai Binggao, Wang Qi, Du Jianlong, Chen Tao, Qian Yafen, Zhu Zhenqiang, Feng Zhiying, Kang Xianhui
Department of Anesthesiology, Tongxiang First People's Hospital, Zhejiang, China.
Department of Pain, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Pain Ther. 2023 Apr;12(2):323-337. doi: 10.1007/s40122-022-00456-z. Epub 2022 Dec 9.
Breast surgery, especially radical mastectomy, is often accompanied by moderate to severe acute pain, which significantly reduces postoperative quality of life. Effective pain management can accelerate patient recovery. Serratus anterior plane block (SAPB) is a new type of fascial plane block technique, which can better target the nerve network innervating the chest wall and breast and provide good analgesia in the anterolateral chest wall. Current clinical research evidence indicates that SAPB has significant benefits in breast surgery. Further research avenues for this technology include optimal local anesthetic dosing strategy, the type of SAPB which is more suitable for breast surgery, comparison of SAPB and pectoral nerve block II (PECS II) in breast surgery, and high-quality randomized controlled study with outcomes of chronic pain or cancer prognosis.
乳房手术,尤其是根治性乳房切除术,常伴有中度至重度急性疼痛,这会显著降低术后生活质量。有效的疼痛管理可以加速患者康复。前锯肌平面阻滞(SAPB)是一种新型的筋膜平面阻滞技术,它可以更好地靶向支配胸壁和乳房的神经网络,并在前外侧胸壁提供良好的镇痛效果。目前的临床研究证据表明,SAPB在乳房手术中具有显著优势。该技术的进一步研究方向包括最佳局部麻醉药给药策略、更适合乳房手术的SAPB类型、乳房手术中SAPB与胸肌神经阻滞II(PECS II)的比较,以及以慢性疼痛或癌症预后为结局的高质量随机对照研究。