Aggarwal Deepak, Singhal Amit, Saraya Chetan, Valecha U K, Goel Ashish
Department of Anaesthesiology, Kanti Devi Medical College and Hospital, Mathura, IND.
Liver Transplantation, B. L. Kapur (BLK) MAX Super Speciality Hospital, Delhi, IND.
Cureus. 2025 Aug 8;17(8):e89599. doi: 10.7759/cureus.89599. eCollection 2025 Aug.
Breast cancer incidence has been rising in recent years, particularly among younger women, and it is now the leading cancer among Indian females. Acute postoperative pain is a significant concern, often deterring patients from surgery. Combining regional anesthesia with intravenous analgesics can improve postoperative outcomes. This study compares two concentrations of ropivacaine for managing postoperative pain in breast cancer surgeries.
Patients were randomized into two groups: Group 1 received 0.375% ropivacaine, and Group 2 received 0.2% ropivacaine via ultrasound-guided pectoral nerve block after anesthesia induction for breast surgeries. Baseline vitals were recorded. Intraoperative analgesia included fentanyl, IV paracetamol, and nerve block. Postoperative vitals and pain scores were monitored at regular intervals, with rescue analgesia provided through patient-controlled IV fentanyl. Statistical analysis used Chi-square or Fisher's exact tests for nominal categorical data and Mann-Whitney U or Wilcoxon Rank Sum tests for non-normal continuous variables.
Both groups were comparable in demographic data. Postoperative systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) measured at fixed intervals showed no significant differences between the groups. Pain scores on the numeric rating scale were also similar. While total 24-hour fentanyl consumption did not differ significantly, average fentanyl use was lower in Group 1.
This study found no significant difference in postoperative pain, antiemetic requirements, or patient satisfaction between 0.375% and 0.2% ropivacaine. While 0.2% ropivacaine is equally effective in terms of analgesia and patient satisfaction, 0.375% may be preferred in scenarios requiring prolonged sensory blockade. While 0.2% ropivacaine is equally effective in terms of analgesia and patient satisfaction, 0.375% may be preferred in scenarios requiring prolonged sensory blockade.
近年来，乳腺癌发病率一直在上升，尤其是在年轻女性中，目前它是印度女性中最主要的癌症。急性术后疼痛是一个重大问题，常常使患者对手术望而却步。将区域麻醉与静脉镇痛药联合使用可改善术后效果。本研究比较了两种浓度的罗哌卡因用于管理乳腺癌手术术后疼痛的效果。
患者被随机分为两组：第1组接受0.375%的罗哌卡因，第2组在乳腺癌手术麻醉诱导后通过超声引导下胸段神经阻滞接受0.2%的罗哌卡因。记录基线生命体征。术中镇痛包括芬太尼、静脉注射对乙酰氨基酚和神经阻滞。术后定期监测生命体征和疼痛评分，通过患者自控静脉注射芬太尼提供补救镇痛。对于名义分类数据，统计分析使用卡方检验或费舍尔精确检验；对于非正态连续变量，使用曼-惠特尼U检验或威尔科克森秩和检验。
两组在人口统计学数据方面具有可比性。在固定时间间隔测量的术后收缩压（SBP）、舒张压（DBP）和脉搏率（PR）在两组之间没有显著差异。数字评分量表上的疼痛评分也相似。虽然24小时芬太尼总消耗量没有显著差异，但第1组的平均芬太尼用量较低。
本研究发现0.375%和0.2%的罗哌卡因在术后疼痛、止吐需求或患者满意度方面没有显著差异。虽然0.2%的罗哌卡因在镇痛和患者满意度方面同样有效，但在需要延长感觉阻滞的情况下，0.375%的罗哌卡因可能更受青睐。虽然0.2%的罗哌卡因在镇痛和患者满意度方面同样有效，但在需要延长感觉阻滞的情况下，0.375%的罗哌卡因可能更受青睐。
