From the Dolan Park Hospital.
King's College London.
Plast Reconstr Surg. 2024 Jan 1;153(1):1e-9e. doi: 10.1097/PRS.0000000000010492. Epub 2023 Apr 4.
Postoperative acute and chronic pain following breast surgery is a common complication that needs resolving to allow for improved patient outcomes. Previously, thoracic epidurals and paravertebral blocks have been the accepted standard administered intraoperatively. However, more recently the introduction of the pectoral nerve block (PECS and PECS-2 blocks) has appeared promising to control the pain more effectively, but further robust analysis is required to prove its efficacy. The authors aim to study the efficacy of a new block, S-PECS, that combines a serratus anterior and a PECS-2 block.
In this study, the authors performed a single-center, randomized, controlled, double-blind group trial in 30 female patients undergoing breast augmentation surgery with silicone breast implants and the S-PECS block. Divided into two groups of 15, the PECS group received local anesthetics and the no-PECS control group received a saline injection. All participants were followed up at recovery and at 4, 6, and 12 hours postoperatively.
The authors' results showed that the pain score in the PECS group was significantly less than in the no-PECS group across all time points: recovery, and at 4, 6, and 12 hours. Furthermore, the patients who received the S-PEC block were 74% less likely to request pain medications compared with the no-PECS group ( P < 0.05).
Overall, the modified S-PECS block is an effective, efficient, and safe method of controlling pain in patients undergoing breast augmentation surgery, with additional applications yet to be explored.
乳房手术后的急性和慢性疼痛是一种常见的并发症,需要解决,以改善患者的预后。以前,胸段硬膜外和椎旁阻滞一直是术中应用的公认标准。然而,最近出现的胸肌神经阻滞(PECS 和 PECS-2 阻滞)似乎更有希望更有效地控制疼痛,但需要进一步的稳健分析来证明其疗效。作者旨在研究一种新的阻滞方法,即 S-PECS,该方法结合了前锯肌和 PECS-2 阻滞。
在这项研究中,作者在 30 名接受硅胶乳房植入物隆乳术的女性患者中进行了一项单中心、随机、对照、双盲分组试验。将患者分为两组,每组 15 人,PECS 组接受局部麻醉,无 PECS 对照组接受生理盐水注射。所有参与者在恢复时以及术后 4、6 和 12 小时进行随访。
作者的结果表明,在所有时间点(恢复时,以及术后 4、6 和 12 小时),PECS 组的疼痛评分明显低于无 PECS 组。此外,与无 PECS 组相比,接受 S-PEC 阻滞的患者要求使用止痛药的可能性降低了 74%(P<0.05)。
总的来说,改良的 S-PECS 阻滞是一种控制隆乳术患者疼痛的有效、高效和安全的方法,还有更多的应用有待探索。