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罗哌卡因肋间神经阻滞联合患者自控静脉镇痛对隆乳术后镇痛效果的影响。

Effect of Ropivacaine Intercostal Nerve Block Combined with Patient Controlled Intravenous Analgesia on Postoperative Analgesia after Breast Augmentation.

机构信息

Department of Cosmetology, Chongqing Huamei Plastic Surgery Hospital, Chongqing, 400015, China.

Department of Anesthesiology, Chongqing Huamei Plastic Surgery Hospital, Chongqing, 400015, China.

出版信息

Aesthetic Plast Surg. 2024 Oct;48(20):4137-4141. doi: 10.1007/s00266-024-03856-y. Epub 2024 Feb 22.

DOI:10.1007/s00266-024-03856-y
PMID:38388796
Abstract

BACKGROUNDS

To observe the effect of ropivacaine intercostal nerve block combined with PCIA as early postoperative analgesia following breast augmentation surgery with prosthesis (axillary approach) METHODS: A total of 80 women with breast augmentation surgery were selected in the plastic surgery department of Chongqing Huamei Plastic Surgery Hospital from December 2021 to May 2022. They were equally randomized into control group and observation group, with 40 cases in each one. Before placing the prosthesis, the control group was given 0.9% normal saline for intercostal nerve block; the observation group was given 0.75% ropivacaine + 1‰ adrenaline for intercostal nerve block. Patient controlled intravenous analgesia (PCIA) was used after operation. Observation indexes the visual analog scale (VAS) of resting and motor state at 4 h, 24 h, 48 h and 72 h after operation and the adverse reactions.

RESULTS

The VAS scores of patients at rest and exercise and adverse reactions in the observation group were lower than those in the control group (P<0.05).

CONCLUSION

Ropivacaine intercostal nerve block combined with PCIA can effectively alleviate the pain after breast augmentation with pectoralis major prosthesis through axillary incision, help patients more comfortably through the perioperative period, accelerate postoperative recovery, reduce the dosage of systemic opioids and effectively reduce side effects.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

观察罗哌卡因肋间神经阻滞联合 PCIA 作为假体隆乳术(腋窝入路)术后早期镇痛的效果。

方法

选取 2021 年 12 月至 2022 年 5 月重庆华美整形外科医院整形科收治的 80 例行假体隆乳术患者,采用随机数字表法分为对照组和观察组,每组 40 例。在放置假体前,对照组给予 0.9%生理盐水肋间神经阻滞,观察组给予 0.75%罗哌卡因+1‰肾上腺素肋间神经阻滞。术后采用患者自控静脉镇痛(PCIA)。观察指标:术后 4、24、48、72 h 静息和运动状态时的视觉模拟评分(VAS)及不良反应。

结果

观察组患者静息和运动时的 VAS 评分及不良反应均低于对照组(P<0.05)。

结论

罗哌卡因肋间神经阻滞联合 PCIA 可有效缓解经腋窝切口行胸大肌假体隆乳术后疼痛,有助于患者更舒适地度过围手术期,加速术后恢复,减少全身阿片类药物的用量,有效减少不良反应。

证据水平 II:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266 。

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