Quan Yan, Liu Yinhua, Li Gang, Liu Zhongyu
Department of Anesthesiology, Maternity and Child Care Center of Qinhuangdao Qinhuangdao 066000, Hebei, China.
Am J Transl Res. 2023 May 15;15(5):3468-3475. eCollection 2023.
To analyze the application of ultrasound-guided thoracic nerve block (TNB) in the operation of benign breast tumors.
A retrospective analysis was conducted on 69 patients who underwent resection of benign breast tumors (fibroma, segment) in the Maternity and Child Care Center of Qinhuangdao from January 2021 to June 2022. Among them, 33 patients who received TNB were assigned to an observation group, and 36 patients who received local infiltration anesthesia were assigned to a control group. The heart rate (HR) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) of patients were recorded before anesthesia (T0), at skin incision (T1), at 0.5 h after operation (T2) and before leaving the operating room (T3). We also recorded the operation indexes, comprising operation time, total propofol dosage administered during operation, anesthesia recovery time and extubation time. The visual analogue scale (VAS) score was evaluated at 0.5, 2, 4 and 6 h after the operation. The two groups were also compared in terms of the levels of immunoglobulin (Ig) A, IgG, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). The postoperative adverse reactions in the two groups were statistically analyzed.
Compared with the observation group, the control group experienced a longer operation time, anesthesia recovery time and extubation time and consumed more propofol (P < 0.001). At T0 and T1, the two groups were not notably different in SBP, DBP and HR (P > 0.05), but at T2 and T3, the control group showed higher SBP, DBP and HR than the observation group (P < 0.001). The control group exhibited notably higher VAS scores than the observation group (P < 0.001). Before operation, the differences in the levels of IgA, IgG, IL-6 and TNF-α were not significantly different between the two groups (P > 0.05), while after operation and at 24 h after operation, the control group showed higher levels of IgA, IgG, IL-6 and TNF-α in comparison to the observation group (P < 0.01). The incidences of adverse reactions were not significantly different between the two groups (P > 0.05).
Ultrasound-guided TNB can substantially reduce both the operation time and the postoperative pain in patients with benign breast tumors, without increasing the incidence of adverse reactions.
分析超声引导下胸段神经阻滞(TNB)在良性乳腺肿瘤手术中的应用。
回顾性分析2021年1月至2022年6月在秦皇岛市妇幼保健中心接受良性乳腺肿瘤(纤维瘤、节段性)切除术的69例患者。其中,33例接受TNB的患者被分配到观察组,36例接受局部浸润麻醉的患者被分配到对照组。记录患者在麻醉前(T0)、皮肤切开时(T1)、术后0.5小时(T2)和离开手术室前(T3)的心率(HR)、收缩压(SBP)和舒张压(DBP)。我们还记录了手术指标,包括手术时间、术中丙泊酚总用量、麻醉恢复时间和拔管时间。在术后0.5、2、4和6小时评估视觉模拟量表(VAS)评分。还比较了两组免疫球蛋白(Ig)A、IgG、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平。对两组术后不良反应进行统计学分析。
与观察组相比,对照组手术时间、麻醉恢复时间和拔管时间更长,丙泊酚用量更多(P<0.001)。在T0和T1时,两组的SBP、DBP和HR无显著差异(P>0.05),但在T2和T3时,对照组的SBP、DBP和HR高于观察组(P<0.001)。对照组的VAS评分显著高于观察组(P<0.001)。术前,两组IgA、IgG、IL-6和TNF-α水平差异无统计学意义(P>0.05),而术后及术后24小时,对照组的IgA、IgG、IL-6和TNF-α水平高于观察组(P<0.01)。两组不良反应发生率差异无统计学意义(P>0.05)。
超声引导下TNB可显著缩短良性乳腺肿瘤患者的手术时间并减轻术后疼痛,且不增加不良反应发生率。