Hu Huiying, Luo Zisu, Li Bixi, Wang Tingting, Wu Tanguan, Li Bin, Song Xiaoyang
Department of Anesthesiology, General Hospital of Central Theater Command of People's Liberation Army, Wuhan, China.
Hubei University of Medicine, Shiyan, China.
Saudi J Anaesth. 2025 Apr-Jun;19(2):235-242. doi: 10.4103/sja.sja_398_24. Epub 2025 Mar 25.
The pectoral nerve (PecS) II block is a recently introduced technique utilized for surgical anesthesia and postoperative analgesia during breast surgery. This study aims to investigate the impact of ultrasound-guided PecS II block on the incidence of chronic postmastectomy pain in patients following radical mastectomy.
Ninety-eight patients undergoing selective radical mastectomy were included in this study. Based on whether the ultrasound-guided PecS II block was performed, the patients were randomly divided into the PecS II block group (group P) and the control group (group C). The primary outcomes included the incidence of chronic pain at 12 weeks after surgery, and the secondary outcomes included intraoperative dosage of remifentanil, the amount of oxycodone used in 48 h after surgery, time for the first analgesia administration, postoperative acute pain score 48 h after surgery, and HADS score at 48 h and 12 weeks after surgery. The presence or absence of pain in the previous week was recorded every 7 days after surgery (beginning on the 8 day after surgery). The postoperative pain duration curves of the two groups were plotted and compared by Kaplan-Meier estimation and log-rank test.
Compared with group C, the incidence of chronic pain in group P at 12 weeks after surgery was significantly decreased by 14.13% (20.65% vs. 34.78%, < 0.05). The amount of remifentanil used in group P was significantly reduced (1.46 ± 0.11 mg vs. 2.66 ± 0.18 mg, < 0.001), and the amount of oxycodone used 48 h after surgery in group P was remarkably reduced than that in group C (22.57 ± 3.21 mg vs. 31.62 ± 4.71 mg, < 0.001). The first analgesic requirement time of group P was significantly longer than that of group C (368.80 ± 157.68 min vs. 96.60 ± 40.12 min, < 0.001). Compared with group C, the postoperative acute pain score 48 h after surgery and the HADS score 48 h and 12 weeks after surgery in group P were significantly decreased ( < 0.05). The postoperative pain duration curve of the two groups was significantly different ( < 0.05), and the postoperative pain duration of group P was lower than that of group C ( < 0.05).
PecS II block can reduce the incidence of chronic postmastectomy pain after radical mastectomy, reduce perioperative opioid consumption, provide better analgesia, and improve the degree of anxiety and depression of patients.
ChiCTR2200066968, 22/12/2022.
胸肌神经（PecS）Ⅱ阻滞是一种最近引入的技术，用于乳房手术中的手术麻醉和术后镇痛。本研究旨在探讨超声引导下PecSⅡ阻滞对根治性乳房切除术后患者慢性乳房切除术后疼痛发生率的影响。
本研究纳入了98例行选择性根治性乳房切除术的患者。根据是否进行超声引导下PecSⅡ阻滞，将患者随机分为PecSⅡ阻滞组（P组）和对照组（C组）。主要结局包括术后12周慢性疼痛的发生率，次要结局包括术中瑞芬太尼用量、术后48小时羟考酮用量、首次镇痛给药时间、术后48小时急性疼痛评分以及术后48小时和12周的医院焦虑抑郁量表（HADS）评分。术后每7天（从术后第8天开始）记录前一周是否存在疼痛。绘制两组的术后疼痛持续时间曲线，并通过Kaplan-Meier估计和对数秩检验进行比较。
与C组相比，P组术后12周慢性疼痛的发生率显著降低了14.13%（20.65%对34.78%，P<0.05）。P组瑞芬太尼用量显著减少（1.46±0.11mg对2.66±0.18mg，P<0.001），且P组术后48小时羟考酮用量明显低于C组（22.57±3.21mg对31.62±4.71mg，P<0.001）。P组首次镇痛需求时间显著长于C组（368.80±157.68分钟对96.60±40.12分钟，P<0.001）。与C组相比，P组术后48小时急性疼痛评分以及术后48小时和12周的HADS评分均显著降低（P<0.05）。两组的术后疼痛持续时间曲线有显著差异（P<0.05），且P组的术后疼痛持续时间低于C组（P<0.05）。
PecSⅡ阻滞可降低根治性乳房切除术后慢性乳房切除术后疼痛的发生率，减少围手术期阿片类药物的消耗，提供更好的镇痛效果，并改善患者的焦虑和抑郁程度。
ChiCTR2200066968，2022年12月22日。
