Al-Dardery Nada M, Khaity Abdulrhman M, Albakri Khaled A, Abdelsattar Ahmed T, Benmelouka Amira Y, Lee Theodore, Foppiani Jose A, Lin Samuel J
Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Faculty of Medicine, Elrazi University, Khartoum, Sudan.
Ann Med Surg (Lond). 2023 Dec 13;86(2):1003-1011. doi: 10.1097/MS9.0000000000001622. eCollection 2024 Feb.
This meta-analysis aimed to compare the efficacy of preservation of the intercostobrachial nerve (ICBN) versus its dissection for patients who underwent breast surgery.
The authors searched Web of Science, PubMed, Cochrane CENTRAL, and Scopus from inception until March 2023. Records were screened for eligible studies, and all relevant outcomes were pooled as an odds ratio (OR) with the corresponding 95% CI in the meta-analysis models using RevMan version 5.4.
These results from 11 studies (1021 patients) favored preservation of the ICBN over its dissection in terms of anaesthesia and hypaesthesia [OR 0.50, (95% CI, 0.31-0.82); = 0.006] and [OR 0.33, (95% CI, 0.16-0.68); = 0.003], respectively. Whereas the overall effect favored ICBN dissection over preservation in the case of hyperaesthesia [OR 4.34, (95% CI, 1.43-13.15); = 0.01]. Conversely, no significant variance was detected between the two groups in terms of pain [OR 0.68, (95% CI, 0.28-1.61) = 0.38], paraesthesia [OR 0.88, (95% CI, 0.49-1.60); = 0.68], and analgesia [OR 1.46, (95% CI, 0.05-45.69); = 0.83].
This meta-analysis revealed that the preservation of the ICBN has a significant effect on the disturbance of sensory parameters of hypaesthesia and anaesthesia when compared to its dissection. Further studies with larger sample sizes are recommended to precisely compare both techniques on a wider range of parameters.
本荟萃分析旨在比较保留肋间臂神经（ICBN）与切断该神经对接受乳房手术患者的疗效。
作者检索了从创刊至2023年3月的Web of Science、PubMed、Cochrane CENTRAL和Scopus数据库。筛选符合条件的研究记录，并使用RevMan 5.4版本在荟萃分析模型中将所有相关结果汇总为比值比（OR）及相应的95%置信区间（CI）。
11项研究（1021例患者）的结果表明，在麻醉和感觉减退方面，保留ICBN优于切断ICBN，其OR分别为0.50（95%CI，0.31 - 0.82）；P = 0.006]和[OR 0.33，（95%CI，0.16 - 0.68）；P = 0.003]。而在感觉过敏方面，总体结果显示切断ICBN优于保留ICBN [OR 4.34，（95%CI，1.43 - 13.15）；P = 0.01]。相反，两组在疼痛[OR 0.68，（95%CI，0.28 - 1.61）；P = 0.38]、感觉异常[OR 0.88，（95%CI，0.49 - 1.60）；P = 0.68]和镇痛[OR 1.46，（95%CI，0.05 - 45.69）；P = 0.83]方面未检测到显著差异。
本荟萃分析表明，与切断ICBN相比，保留ICBN对感觉减退和麻醉等感觉参数的干扰有显著影响。建议进行更大样本量的进一步研究，以在更广泛的参数范围内精确比较这两种技术。
