超声引导前锯肌阻滞对乳腺癌患者术后疼痛的影响  

Effects of serratus anterior plane block on postoperative pain after modified radical mastectomy

作　　者：王棕皆 曾繁培 钱彬[2] 卢浩杰[2] 陈亭亭[2] 

机构地区：[1]福建医科大学附属龙岩第一医院麻醉科,福建龙岩364000 [2]福建中医药大学附属人民医院麻醉科,福州350004

出　　处：《创伤与急诊电子杂志》2017年第2期55-58,共4页Journal of Trauma and Emergency(Electronic Version)

基　　金：福建省医学创新课题(2015-CXB-24);福建省中青年教师教育科研项目资助(JA160234)

摘　　要：目的探讨超声引导前锯肌阻滞对乳腺癌患者术后疼痛的影响。方法选择行乳腺癌改良根治手术患者52例,年龄32~56岁,美国麻醉医师协会(American society of anesthesiologists,ASA)分级为Ⅰ或Ⅱ级,随机分为研究组和对照组(n=26)。麻醉诱导前行超声引导下手术侧前锯肌阻滞,研究组注射0.5%罗哌卡因20 ml;对照组注射0.9%氯化钠溶液20ml。观察患者术后1、2、4、8、24、48小时静息状态疼痛程度;恶心呕吐等不良反应发生率和患者满意度评分。结果与对照组比较,研究组患者术后1、2、4、8、24小时的视觉模拟评分降低;镇痛泵按压次数较少(8.6±2.7 vs.20.6±7.9)、补救镇痛率较低(11.5%vs 38.5%);术后恶心、呕吐发生率降低(15.4%vs.57.7%),以上各项指标差异均有统计学意义(P<0.05)。结论超声引导前锯肌阻滞可以减轻患者术后疼痛,减少术后恶心、呕吐等不良反应。Objective To evaluate the effects of ultrasound-guided serratus anterior plane block （SAPB） on the postoperative pain after modified radical mastectomy. Methods Fifty- two American Society of Anesthesiologists （ASA） physical status Ⅰ or Ⅱ patients undergoing modified radical mastectomy were randomly allocated to SAPB group or control group. The SAPB group received SAPB with 20 ml of 0.5% ropivacaine, whereas the control group received SAPB with 20 ml of 0.9% NaC1. The outcomes included postoperative rest pain intensity, which was assessed at lh, 2h, 4h, 8h, 24h and 48h after surgery using the visual analogue scale （VAS）, the incidence of postoperative nausea and vomiting （PONV） and patient＇s satisfaction. Results Compared with the control group, VAS scores at lh, 2h, 4h, 8h, 24h and 48h after surgery, the frequency of analgesia purnps（8.6±2.7 vs. 20.6±7.9, P〈 0.05）and additional analgesic use（11,5% vs. 38.5 %, P〈0.05）were all significantly decreased. The incidence of PONV was significantly reduced（15.4% vs. 57.7%, P〈0.05）. Conclusion Ultrasound-guided SAPB can enhance the postoperative analgesia and patient＇s satisfaction for modified radical mastectomy.

关 键 词：前锯肌 阻滞 疼痛 手术后 超声引导 乳腺癌改良根治术 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]