超声引导下肋横突孔阻滞和竖脊肌平面阻滞在乳腺癌患者术后镇痛效果的比较  

Ultrasound-guided costotransverse foramen block versus erector spinae plane block for postoperative analgesic effect in patients with breast cancer surgery

作　　者：郑小兰[1] 陈陵[2] 张学康[1] 陈世彪[1] 肖苏军 ZHENG Xiao-lan;CHEN Ling;ZHANG Xue-kang;CHEN Shi-biao;XIAO Su-jun(Department of Anesthesiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi,China;不详)

机构地区：[1]南昌大学第一附属医院麻醉科,江西南昌330006 [2]南昌大学第一附属医院医务科,江西南昌330006

出　　处：《广东医学》2023年第2期214-218,共5页Guangdong Medical Journal

基　　金：江西省卫健委科技计划项目(20203223)。

摘　　要：目的评价超声引导下肋横突孔阻滞(CFB)和竖脊肌平面阻滞(ESPB)对乳腺癌患者术后镇痛效果的影响。方法选择2020年7月至2021年12月行乳腺癌根治术的女性患者80例,年龄20~75岁,体质指数(BMI)22~33 kg/m^(2),ASAⅡ或Ⅲ级。采用随机数字法分为两组:CFB组与ESPB组,每组40例。每组在全麻后分别进行超声引导下CFB与ESPB,选择T_(4)横突水平,注射0.375%盐酸罗哌卡因0.4 mL/kg。术毕两组均行患者自控静脉镇痛。记录在PACU拔管时间和停留时间。记录拔管后即时及术后2、4、12、24 h疼痛VAS评分。镇痛泵有效按压次数、补救镇痛情况、穿刺不良反应与相关并发症等发生情况。结果PACU拔管时间CFB组明显短于ESPB组(P<0.05),拔管后即时及术后2、4、12 h CFB组的VAS疼痛评分明显低于ESPB组(P<0.05),镇痛泵有效按压次数明显少于ESPB组(P<0.05),补救镇痛率CFB组明显低于ESPB组(P<0.05)。结论与ESPB比较,CFB可以有效缓解乳腺癌手术患者的术后疼痛,也减少了术后镇痛药物的使用,提高患者的舒适度。Objective To evaluate the effect of ultrasound-guided costotransverse foramen block(CFB)and erector spinae plane block(ESPB)on postoperative analgesia in patients with breast cancer surgery.Methods Eighty women undergoing radical mastectomy surgery from July 2020 to December 2021,aged 20-75 years,with BMI 22-33 kg/m^(2) and ASA Ⅱ orⅢ,were randomly divided into 2 groups(n=40):Group CFB and Group ESPB.After general anesthesia,Group CFB and Group ESPB received ultrasound-guided costotransverse foramen block and erector spinae plane block,respectively.Patients in both groups were given with patient-controlled intravenous analgesia(PCIA)after operation.PACU extubation and retention time,VAS pain scores immediately after extubation and 2,4,12 and 24 hours after operation,PCIA effective press times,rescue analgesia rate,puncture related complications and adverse reactions were recorded.Results VAS pain scores immediately after extubation and 2,4 and 12 hours after operation in Group CFB were significantly lower than those in Group ESPB(P<0.05).The extubation time of PACU,the effective pressing times of PCIA,and rescue analgesia rate in Group CFB were significantly less than those in Group ESPB(P<0.05).Conclusion Compared with erector spinae plane block,ultrasound-guided costotransverse foramen block can effectively alleviate the postoperative pain in patients with radical mastectomy surgery,reduce the use of postoperative analgesic drugs,and improve the comfort of the patients.

关 键 词：竖脊肌平面阻滞 肋横突孔阻滞 超声引导 乳腺癌 镇痛 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]