摘要
目的探讨超声引导下胸神经Ⅱ(PecsⅡ)阻滞和胸椎旁神经(TPVN)阻滞对乳腺癌根治术患者镇痛效果、麻醉药物用量及并发症的影响。方法将80例行乳腺癌根治术的患者按阻滞方式不同分为P组(43例)和T组(37例),P组患者在超声引导下行PecsⅡ阻滞,T组患者予以超声引导下TPVN阻滞,两组术后均予以经静脉自控镇痛。比较两组患者术后镇痛时间、术后24 h内麻醉药物用量、术后疼痛情况、各胸段皮区痛觉减退情况及并发症发生率。结果P组患者术后镇痛时间明显长于T组,麻醉药物用量明显少于T组,差异均有统计学意义(P﹤0.01)。术后1、5、8 h,P组患者视觉模拟评分(VAS)均明显低于T组,差异均有统计学意义(P﹤0.01)。P组患者T2节段皮区痛觉减退率高于T组,T6节段皮区痛觉减退率低于T组,差异均有统计学意义(P﹤0.05)。P组患者并发症总发生率为2.33%(1/43),低于T组的21.62%(8/37),差异有统计学意义(P﹤0.05)。结论相较于TPVN阻滞,超声引导下PecsⅡ阻滞应用于乳腺癌根治术患者安全有效,能够减少麻醉药物用量,延长镇痛时间,镇痛效果更佳,并发症发生率更低。
Objective To explore the effects of ultrasound-guided pectoral nerve Ⅱ(Pecs Ⅱ) block and thoracic paravertebral nerve(TPVN) block on analgesic effect, dosage of anesthetics and complications of patients undergoing radical mastectomy for breast cancer. Method A total of 80 patients underwent radical mastectomy were divided into group P(n=43) and group T(n=37) according to the difference blocking methods. The group P received ultrasound-guided Pecs Ⅱ block, and the group T received ultrasound-guided TPVN block, and the both groups were treated by intravenous autocontrol and analgesia after operation. The postoperative analgesia time, anesthesia drug use and postoperative pain within 24 hours after operation between the two groups were compared. Result The postoperative analgesia time in group P was significantly longer than that in the group T(P<0.01), and the dosage of anesthetics in group P was significantly less than that in group T(P<0.01). The visual analogue scale(VAS) scores at 1, 5, 8 h after operation in group P were significantly lower than those in group T(P<0.01). The pain reduction rate of T2 segment in group P was higher than that in group T, while that in T6 was lower than that in group T(P<0.05). The total incidence of complications in group P was 2.33%(1/43), which was statistically lower than that in group T 21.62%(8/37)(P<0.05). Conclusion Compared to TPVN block, the ultrasound-guided Pecs Ⅱ block is safe and effective for patients undergoing radical mastectomy. It can reduce the dosage of anesthetics, prolong the analgesia time, which has better analgesic effect and less incidence of complications.
作者
周一鸣
惠康祥
曹文珺
涂立刚
ZHOU Yiming;HUI Kangxiang;CAO Wenjun;TU Ligang(Department of Anesthesia,Xinyang Central Hospital,Xinyang 464000,He’nan,China)
出处
《癌症进展》
2020年第21期2220-2223,共4页
Oncology Progress
关键词
超声引导
胸神经Ⅱ阻滞
胸椎旁神经阻滞
乳腺癌根治术
ultrasound-guided
pectoral nerve Ⅱ block
thoracic paravertebral nerve block
radical mastectomy
