超声引导下前锯肌平面阻滞在乳腺微创旋切术中的应用  

Application of ultrasound-guided serratus anterior plane block in minimally invasive breast atherectomy

作　　者：林少标 李国权 邓海泽 Lin Shaobiao;Li Guoquan;Deng Haize(The Sixth People's Hospital of Huizhou City,Huizhou,Guangdong 516200)

机构地区：[1]惠州市第六人民医院,广东惠州516200

出　　处：《基层医学论坛》2023年第2期1-4,共4页The Medical Forum

基　　金：惠州市科技计划项目(200413104579532)。

摘　　要：目的研究超声引导下前锯肌平面阻滞(SAPB)在乳腺微创旋切术中的应用价值。方法选择2020年3月-2022年3月在惠州市第六人民医院需要接受超声引导下乳腺肿物微创旋切术治疗的200例患者,将其按照归倾向匹配的方法分为SAPB组(接受超声引导下前锯肌平面阻滞麻醉)和局部浸润麻醉组(接受传统局部浸润麻醉)。对比2组患者手术后不同时点的疼痛和镇静评分、术毕血压和心率、术中麻醉药物使用总剂量以及术后并发症发生率。结果术后60,120,240以及480min,SAPB组的疼痛评分均明显低于局部浸润麻醉组(P<0.05);术后60,120,240以及480min,SAPB组的镇静评分均明显稳定于局部浸润麻醉组(P<0.05);SAPB组的丙泊酚、瑞芬太尼和舒芬太尼用量均明显少于局部浸润麻醉组(P<0.05);手术完毕时SAPB组的收缩压明显高于局部浸润麻醉组,心率和舒张压则明显低于局部浸润麻醉组(P<0.05);SAPB组并发症发生率为5%,明显低于局部浸润麻醉组的20%(P<0.05)。结论对需要接受乳腺肿物微创旋切术治疗的患者,采用超声引导下前锯肌平面阻滞麻醉方式,有助于减少麻醉药物用量,可避免术后出现明显的疼痛,有利于加快康复进程,值得临床推广。Objective To study the application value of ultrasound-guided serratus anterior plane block(SAPB)in minimally invasive breast atherectomy.Methods A total of 200 patients who needed ultrasound-guided minimally invasive atherectomy for breast tumors in our hospital from March 2020 to March 2022 were selected,and they were divided into SAPB group(according to the method of regression propensity matching)(receiving ultrasound-guided atherectomy). Inferior serratus anterior plane block anesthesia)and local infiltration anesthesia group(received surgery under traditional local infiltration anesthesia). The pain and sedation scores,postoperative blood pressure and heart rate values,the total dose of intraoperative anesthetics and the incidence of postoperative complications were compared between the two groups of patients at different time points after surgery.Results At 60,120,240,and 480 minutes after the operation,the pain scores of the SAPB group were significantly lower than those of the local infiltration anesthesia group(P<0.05).At 60,120,240 and 480 minutes after the operation,the sedation score of the SAPB group was significantly stable compared with the local infiltration anesthesia group(P<0.05).The dosages of pofol,remifentanil and sufentanil were significantly lower than those in the local infiltration anesthesia group(P<0.05);comparing the blood pressure and heart rate at the end of the operation,the systolic blood pressure in the SAPB group was significantly higher than that in the local infiltration anesthesia group,and the heart rate and heart rate were significantly higher than those in the local infiltration anesthesia group. The diastolic blood pressure was significantly lower than that of the local infiltration anesthesia group(P<0.05);compared with postoperative complications,the incidence of complications in the SAPB group was 5%,which was significantly lower than that in the local infiltration anesthesia group,20%,with significant differences between the two groups(P<0.05).Conclusion For patients

关 键 词：乳腺多发肿物 乳腺微创旋切术 超声引导 前锯肌平面阻滞 

分 类 号：R655.8[医药卫生—外科学]