肋间神经前皮支联合PecsⅡ在全麻乳腺癌根治术中的镇痛效果  

Analgesic efficacy of intercostal nerve block of the anterior cutaneous branches combined with pectoral nerveⅡblock in radical mastectomy performed under general anesthesia

作　　者：李暘 聂洋洋 叶艺峰[1] LI Yang;NE Yang-yang;YE Yi-feng(Department of Anesthesiology,The First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]厦门大学附属第一医院麻醉科,厦门361003

出　　处：《中国肿瘤临床与康复》2020年第9期1053-1056,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨肋间神经前皮支联合Ⅱ型胸神经(PecsⅡ)阻滞用于全麻乳腺癌根治术的镇痛效果。方法选取2018年11月至2019年11月间厦门大学附属第一医院收治的120例行乳腺癌根治术的女性患者,采用随机数字表法分为观察组和对照组,每组60例。对照组患者采用PecsⅡ,观察组患者采用肋间神经前皮支阻滞联合PecsⅡ,比较两组患者围术期相关指标、术后各时间点视觉模拟评分(VAS)和镇静评分(Ramsay)、术后不良反应发生率及镇痛药使用率。结果两组患者手术时间和麻醉时间比较,差异无统计学意义(P>0.05)。观察组患者住院时间短于对照组,差异有统计学意义(P<0.05)。观察组患者术后2h、12h和24h的VAS评分均低于对照组,Ramsay评分均高于对照组,差异均有统计学意义(均P<0.05)。两组患者术后不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者镇痛药物使用率低于对照组,差异有统计学意义(P<0.05)。结论肋间神经前皮支联合PecsⅡ用于全麻乳腺癌根治术的镇静、镇痛效果好,且不会增加不良反应发生率,利于患者术后恢复。Objective To explore the analgesic efficacy of intercostal nerve block of the anterior cutaneous branches combined with pectoral nerveⅡblock in radical mastectomy performed under general anesthesia.Methods A total of 120 patients admitted to The First Affiliated Hospital of Xiamen University from November 2018 to November 2019 who underwent radical mastectomy for breast cancer were selected and divided into an observation group and a control groups by random number table method with 60 patients each.The observation group was given intercostal nerve block of the anterior cutaneous branches combined with pectoral nerveⅡblock and the control group was given pectoral nerveⅡblock.The perioperative indicators,visual analogue scores(VAS)and Ramsay scores,incidence of postoperative adverse reactions and use of analgesics were compared between the two groups.Results There was no significant difference in the operation time and anesthesia time between the two groups(P>0.05).Length of hospital stay was significantly shorter in the observation group than in the control group(P<0.05).VAS scores at 2 h,12 h and 24 h after surgery were significantly lower in the observation group than in the control group(all P<0.05).Ramsay scores were significantly higher in the observation group than in the control group(all P<0.05).There was no significant difference in the incidence of postoperative adverse reactions between the two groups(P>0.05).The rate of utilization for analgesic medicine was significantly lower in the observation group than in the control group(P<0.05).Conclusion The analgesic efficacy of intercostal nerve block of the anterior cutaneous branches combined with pectoral nerveⅡblock was good,which was beneficial to postoperative recovery without increasing the incidence of adverse reactions in patients undergoing radical mastectomy for breast cancer.

关 键 词：肋间神经前皮支 Ⅱ型胸神经阻滞 乳腺癌根治术 镇痛 

分 类 号：R737.4[医药卫生—肿瘤]