Al-Touny Shimaa A, Abd Elnasser Amira G, Al-Taher Ezzat M, El-Lilly Ahmed A
Department of Anesthesia, Intensive Care, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
J Anaesthesiol Clin Pharmacol. 2023 Jan-Mar;39(1):61-66. doi: 10.4103/joacp.joacp_149_21. Epub 2023 Jan 2.
Many drugs have been tried as adjuvant to local anesthetic in different nerve blocks. Ketorolac is one of them, but it has never been used in pectoral nerve block. In this study, we evaluated its adjuvant effect with local anesthetic on postoperative analgesia in ultrasound (US)-guided pectoral nerve (PECS) blocks. The aim was to assess the quality and the duration of analgesia by the addition of ketorolac in the PECS block.
46 patients who underwent modified radical mastectomies under general anesthesia were randomized into two groups: control group, where pectoral nerve block was given with bupivacaine 0.25% only; and ketorolac group, where the block was given with bupivacaine 0.25% and ketorolac 30 mg.
Patients who needed postoperative supplemental analgesia were significantly less in the ketorolac group (9 vs 21 patients, = 0.00) and that first-time analgesic requirement was significantly later in the ketorolac group (14 hrs) postoperatively compared to the control group (9 hrs) postoperatively.
Adding ketorolac to bupivacaine in pectoral nerve block safely increases postoperative duration of analgesia.
许多药物已被尝试作为不同神经阻滞中局部麻醉药的辅助用药。酮咯酸是其中之一，但从未用于胸神经阻滞。在本研究中，我们评估了其与局部麻醉药联合用于超声（US）引导下胸神经（PECS）阻滞对术后镇痛的辅助效果。目的是评估在PECS阻滞中添加酮咯酸后的镇痛质量和持续时间。
46例在全身麻醉下接受改良根治性乳房切除术的患者被随机分为两组：对照组，仅用0.25%布比卡因进行胸神经阻滞；酮咯酸组，用0.25%布比卡因和30mg酮咯酸进行阻滞。
酮咯酸组术后需要补充镇痛的患者明显较少（9例对21例，P = 0.00），且酮咯酸组术后首次镇痛需求明显晚于对照组（分别为术后14小时和9小时）。
在胸神经阻滞中，将酮咯酸添加到布比卡因中可安全地延长术后镇痛时间。
