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新型前锯肌平面阻滞在改良根治性乳房切除术后早期镇痛方面比胸小肌后阻滞更有效。

The new serratus anterior plane block is more effective than the SPB block for early postoperative analgesia following modified radical mastectomy surgery.

作者信息

Gao Ruizhen, Zhou Gang, Zhu Wanting, Zhang Mingyu, Shu Aihua, Zhou Mi

机构信息

Department of Anesthesiology, Wuhan Third Hospital, Wuhan, 430074, China.

Department of Anesthesiology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, 2 Jiefang Road, Xiling District, Yichang City, Hubei, China.

出版信息

Sci Rep. 2025 Jul 7;15(1):24281. doi: 10.1038/s41598-025-04438-x.

Abstract

Serratus anterior plane block (SPB) as a regional anesthesia technique is used for analgesia in modified radical mastectomy (MRM). The new serratus anterior plane (SAP) block is a novel approach that has been described recently. This study aimed to elucidate the effectiveness and safety of SAP block for pain management after MRM and compare the analgesic effects of SPB and SAP block with those of a control group during the postoperative period of MRM. In a prospective randomized controlled trial, sixty patients (n = 60) who underwent MRM surgery received either SPB or SAP block analgesia. The primary endpoint was the visual analog scale (VAS) score (at rest or with movement) at 2 h after MRM. The secondary outcomes were VAS scores at different time points (6, 12, 24 h) after MRM, stress hormone levels, and the consumption of opioid analgesics during the surgery. Sixty subjects were enrolled. The VAS scores with movement at 2 h postoperation were significantly lower in the SAP group than in the SPB group (P = 0.027). The patients in the SAP and SPB groups had lower VAS scores compared with the Control group at 2 and 6 h after MRM, both at rest and with movement (P < 0.001). The SPB and SAP blocks significantly reduced the consumption of opioid analgesics during surgery compared with the control group (P < 0.001). This study revealed that both SPB and SAP blocks had good postoperative analgesic effects on modified radical mastectomy surgery, reduced the consumption of opioids, and decreased the stress response during surgery compared with the control group. Compared with SPB, the SAP block may have better analgesic effects during the early postoperative period of modified radical mastectomy surgery.Trial registration: This study was registered in the Chinese Clinical Trial Registry (Date of Registration: 08/08/2021, registration number: ChiCTR2100049692).

摘要

前锯肌平面阻滞(SPB)作为一种区域麻醉技术,用于改良根治性乳房切除术(MRM)的镇痛。新的前锯肌平面(SAP)阻滞是最近描述的一种新方法。本研究旨在阐明SAP阻滞用于MRM术后疼痛管理的有效性和安全性,并比较MRM术后SPB和SAP阻滞与对照组的镇痛效果。在一项前瞻性随机对照试验中,60例行MRM手术的患者接受了SPB或SAP阻滞镇痛。主要终点是MRM术后2小时的视觉模拟量表(VAS)评分(静息或活动时)。次要结局是MRM术后不同时间点(6、12、24小时)的VAS评分、应激激素水平以及手术期间阿片类镇痛药的消耗量。招募了60名受试者。SAP组术后2小时活动时的VAS评分显著低于SPB组(P = 0.027)。MRM术后2小时和6小时,SAP组和SPB组患者静息和活动时的VAS评分均低于对照组(P < 0.001)。与对照组相比,SPB和SAP阻滞显著减少了手术期间阿片类镇痛药的消耗量(P < 0.001)。本研究表明,与对照组相比,SPB和SAP阻滞对改良根治性乳房切除术均有良好的术后镇痛效果,减少了阿片类药物的消耗量,并降低了手术期间的应激反应。与SPB相比,SAP阻滞在改良根治性乳房切除术后早期可能具有更好的镇痛效果。试验注册:本研究在中国临床试验注册中心注册(注册日期:2021年8月8日,注册号:ChiCTR2100049692)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/648f/12234743/530860a1e9d9/41598_2025_4438_Fig1_HTML.jpg

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