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中国临床研究英文版:2022,35(12):1689-1692,1698
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前锯肌平面阻滞与胸椎旁神经阻滞对乳腺癌术后镇痛和应激反应的影响
(惠州市中心人民医院麻醉科,广东 惠州 516000)
Effects of serratus anterior plane block and thoracic paravertebral block on postoperative analgesia and stress response in breast cancer patients
(Anesthesiology Department of Huizhou Municipal Central Hospital, Huizhou, Guangdong 516000, China)
摘要
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Received:June 29, 2022   Published Online:December 20, 2022
中文摘要: 目的 探讨胸椎旁神经阻滞(TPVB)和前锯肌平面阻滞(SAPB)对乳腺癌术后镇痛及应激反应的影响。方法 选择惠州市中心人民医院2020年1月至2021年12月92例拟行乳腺癌根治术的患者作为研究对象,随机数字表法分为SAPB组(n=31)、TPVB组(n=31)及单纯全麻组(n=30)。SAPB组采用SAPB联合喉罩全身麻醉,TPVB组采用TPVB联合喉罩全身麻醉,单纯全麻组仅采用喉罩全身麻醉。比较三组术后疼痛程度、术后镇痛效果及术前、术后24 h应激反应指标[白细胞介素(IL)-10、IL-6、丙二醛(MDA)];记录三组术后不良反应情况。结果 术后12 h、24 h、48 h、72 h VAS评分TPVB组<SAPB组<单纯全麻组(P<0.05);镇痛有效持续时间TPVB组>SAPB组>单纯全麻组(P<0.05);术后舒芬太尼用量和48 h内自控静脉镇痛(PCIA)有效按压次数TPVB组<SAPB组<单纯全麻组(P<0.05);术后24 h血清IL-10、IL-6、MDA水平TPVB组>SAPB组>单纯全麻组(P<0.05)。结论 TPVB对乳腺癌术后镇痛效果优于SAPB,可以有效缓解患者术后疼痛,延长镇痛有效持续时间,减少镇痛药物用量,缓解机体应激反应。
Abstract:Objective To investigate the influence of thoracic paravertebral block(TPVB) and serratus anterior plane block(SAPB) on postoperative analgesia and stress response in patients with breast cancer. Methods A total of 92 patients who planned to receive radical mastectomy from January 2020 to December 2021 in Huizhou Municipal Central Hospital were selected as study objects. All the patients were divided into SAPB group(SAPB + laryngeal mask general anesthesia, n=31), TPVB group(TPVB + laryngeal mask general anesthesia, n=31) and general anesthesia group(laryngeal mask general anesthesia, n=30) according to random number method. The postoperative pain and analgesic effect were compared among the three groups. The stress response indexes [interleukin(IL)-10, IL-6 and malondialdehyde(MDA)]before and 24 hours after operation were compared among the three groups. The adverse reactions of the three groups were recorded. Results The VAS scores at 12 h, 24 h, 48 h and 72 h after operation were as follows: simple anesthesia group>SAPB group>TPVB group(P<0.05). The dosage of sufentanil and the effective press times of patient-controlled intravenous analgesia(PCIA) within 48 hours after operation were as follows: simple anesthesia group>SAPB group>TPVB group(P<0.05). The levels of serum IL-10, IL-6 and MDA at 24 h after operation were as follows: simple anesthesia group>SAPB group>TPVB group(P<0.05). Conclusion TPVB is superior to SAPB in postoperative analgesia for breast cancer, which can effectively relieve postoperative pain of patients, prolong the effective duration of analgesia, reduce the dose of analgesic drugs, and alleviate the stress reaction of the body.
文章编号:     中图分类号:    文献标志码:A
基金项目:广东省惠州市科技计划(卫生医疗)项目(2019Y016)
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