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超声引导下双侧Ⅰ型与Ⅱ型胸神经阻滞用于男性乳房肥大症手术术后镇痛的疗效比较

The Comparison of Efficacy of Bilateral Type I Versus Type II Pectoral Nerve Block Applied with Ultrasound-Guided for Postoperative Analgesia in Gynecomastia Surgeries.

作者信息

Urfalıoglu Aykut, Bekerecioglu Mehmet, Doganer Adem, Karaduman Harun, Satıcı Gizem Ezgi, Dincgözoglu Abdullah

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Avsar Campus, 46100, Onikisubat, Kahramanmaras, Turkey.

Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

出版信息

Aesthetic Plast Surg. 2025 Apr 23. doi: 10.1007/s00266-025-04865-1.

Abstract

BACKGROUND

Gynecomastia surgeries are frequently performed due to esthetic concerns. There is lack of data regarding postoperative pain control for these patients. The aim of this study was to compare the pectoral nerve (PECS) block type I and type II with respect to postoperative analgesic consumption, pain scores in these patients.

METHODS

The prospective randomized study was conducted with 30 patients, with American Society of Anesthesiologists I-II, between the ages of 18 and 50, and undergoing bilateral gynecomastia surgery. The patients were divided into two groups: PECS I block with general anesthesia (n = 15) and PECS II block with general anesthesia (n = 15). The demographic data, hemodynamic parameters, postoperative numeric rating scale (NRS) scores (at 0, 1, 2, 6, 12, 24 h postoperative), the number of patients who needed rescue analgesia, and block-related adverse events were recorded.

RESULTS

NRS scores at 30 min, 1 and 2 h postoperatively were similar in the two groups, whereas the scores at 6, 12 and 24 h were significantly lower in the PECS II group (p = 0.005, p = 0.007, p = 0.002, respectively). It was determined that the postoperative 24-h tramadol consumption was statistically significantly lower in the PECS II group (p = 0.005). Additional analgesic was required in two patients in the PECS I group, but none in the PECS II group.

CONCLUSION

PECS blocks could effectively reduce postoperative pain level in gynecomastia operations; however, PECS II block was superior to PECS I block in terms of both analgesic consumption and pain scores.

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

男性乳房肥大手术因美观问题经常进行。目前缺乏关于这些患者术后疼痛控制的数据。本研究的目的是比较I型和II型胸肌神经(PECS)阻滞在这些患者术后镇痛药物消耗、疼痛评分方面的差异。

方法

对30例美国麻醉医师协会I-II级、年龄在18至50岁之间且接受双侧男性乳房肥大手术的患者进行前瞻性随机研究。患者分为两组:全身麻醉下的PECS I阻滞组(n = 15)和全身麻醉下的PECS II阻滞组(n = 15)。记录人口统计学数据、血流动力学参数、术后数字评分量表(NRS)评分(术后0、1、2、6、12、24小时)、需要补救镇痛的患者数量以及与阻滞相关的不良事件。

结果

两组术后30分钟、1小时和2小时的NRS评分相似,而PECS II组术后6、12和24小时的评分显著更低(分别为p = 0.005、p = 0.007、p = 0.002)。确定PECS II组术后24小时曲马多消耗量在统计学上显著更低(p = 0.005)。PECS I组有2例患者需要额外镇痛,而PECS II组无此情况。

结论

PECS阻滞可有效降低男性乳房肥大手术的术后疼痛程度;然而,在镇痛药物消耗和疼痛评分方面,PECS II阻滞优于PECS I阻滞。

证据水平II:本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述,请参阅目录或作者在线指南www.springer.com/00266

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