SPB联合Pecs Ⅱ阻滞对全麻乳腺癌根治患者麻醉苏醒、镇痛水平及不良反应的影响  

Effect of SPB combined with Pecs Ⅱ Block on Anesthesia Recovery,Analgesia Level and Side Effects of general Anesthesia in Breast Cancer Patients undergoing radical Mastectomy

作　　者：董晓辉[1] 王琦博 张轩宇 DONG Xiaohui;WANG Qibo;ZHANG Xuanyu(Department of Anesthesiology,Shangqiu First People's Hospital,Shangqiu Henan 476200,China)

机构地区：[1]商丘市第一人民医院麻醉科,河南商丘476200

出　　处：《临床研究》2023年第11期36-39,共4页Clinical Research

摘　　要：目的 探究全麻乳腺癌根治患者给予前锯肌平面阻滞(SPB)联合Ⅱ型胸神经(Pecs Ⅱ)阻滞对机体疼痛、不良反应、麻醉苏醒的影响。方法 选取商丘市第一人民医院2019年4月至2021年1月就诊的120例全麻乳腺癌根治患者为研究对象。根据随机数据分组方法分为对照组(Pecs Ⅱ阻滞)与观察组(SPB联合Pecs Ⅱ阻滞),各60例,采用视觉模拟评分量表(VAS)评估两组疼痛程度;分析两组麻醉苏醒时间、自主呼吸时间、意识恢复时间、拔管时间;对比两组免疫功能指标和氧化应激分子;对比两组不良反应发生率;采用Ramsay镇静评分评估镇静程度。结果 观察组3 h、12 h、24 h、48 h VAS评分低于对照组,差异有统计学意义(P<0.05);术后,两组组麻醉苏醒时间对比,观察组患者相对于对照组患者更快恢复意识、意识恢复时间与拔管时间缩短,差异有统计学意义(P<0.05);术后,观察组与对照组免疫功能指标均低于术前,且观察组免疫功能指标高于对照组,差异有统计学意义(P<0.05);术后,两组氧化应激分子比较,观察组超氧化物歧化酶(SOD)指标明显高于对照组,观察组烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(NOX4)、髓过氧化物酶(MPO)、丙二醇(MDA)指标低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率对比,差异无统计学意义(P> 0.05);观察组术后1 h、12 h、24 h、48 h Ramsay评分较对照组低,差异有统计学意义(P<0.05)。结论 SPB联合Pecs Ⅱ麻醉,患者疼痛程度显著减轻,氧化应激水平明显改善,患者可更好苏醒,增强免疫力,以此加快机体恢复,临床应用效果显著。Objective To investigate the effects of sawtooth muscle block(SPB) combined with type Ⅱ thoracic nerve block(Pecs Ⅱ) on pain,adverse reactions and recovery from anesthesia in breast cancer patients under general anesthesia.Methods A total of 120 patients with breast cancer undergoing general anesthesia from April 2019 to January 2021 in the First People's Hospital of Shangqiu City were selected as the study subjects.According to the random data grouping method,the patients were divided into a control group(Pecs Ⅱ block) and an observation group(SPB combined with Pecs Ⅱ block),with 60 patients in each group.The pain level of both groups was evaluated using the Visual Analog Scale(VAS);The awakening time,spontaneous breathing time,consciousness recovery time,and extubation time of two groups of anesthesia were analyzed;The indexes of immune function and oxidative stress molecules were compared between the two groups.The incidence of adverse reactions was compared between the two groups.The degree of sedation was evaluated by Ramsay sedation score.Results After surgery,the VAS scores of the observation group and the control group were lower than before surgery,and the VAS scores of the observation group were lower than those of the control group,with a statistically significant difference(P<0.05);After surgery,the comparison of anesthesia recovery time between the two groups showed that the observation group patients regained consciousness faster,and the recovery time and extubation time were shortened compared to the control group patients,with a statistically significant difference(P<0.05);After surgery,the immune function indicators in the observation group and the control group were lower than before surgery,and the immune function indicators in the observation group were higher than those in the control group,with a statistically significant difference(P<0.05);After surgery,the comparison of oxidative stress molecules between the two groups showed that the superoxide dismutase(SOD) indicators in the obs

关 键 词：SPB PecsⅡ 全麻 乳腺癌根治 麻醉苏醒 镇痛水平 不良反应 

分 类 号：R285.6[医药卫生—中药学]