胸横肌平面-胸神经阻滞联合喉罩全麻在乳腺癌改良根治术中的应用  

Application of transverse pectoral muscle plane thoracic nerve block combined with laryngeal mask airway general anesthesia in modified radical surgery for breast cancer

作　　者：杨善林 颜查根 YANG Shanlin;YAN Chagen(Department of Anesthesiology,Huaining County People’s Hospital,Anqing,Anhui 246100,China)

机构地区：[1]安徽省怀宁县人民医院麻醉科,安徽安庆246100

出　　处：《医药前沿》2023年第25期13-16,共4页Journal of Frontiers of Medicine

基　　金：2021年安庆市立医院怀宁院区(怀宁县人民医院)三新技术项目[16号]。

摘　　要：目的:分析胸横肌平面-胸神经阻滞联合喉罩全麻在乳腺癌改良根治术中的应用价值。方法:选取2021年1月—2022年12月于安徽省怀宁县人民医院拟行乳腺癌改良根治术治疗的40例患者,利用随机数字表法分为研究组和对照组,对照组单纯接受喉罩全麻,研究组接受胸横肌平面-胸神经阻滞联合喉罩全麻,观察两组患者的手术相关指标、血流动力学指标,以及术后疼痛评分及不良反应发生情况。结果:两组患者的手术时间、术中出血量及术中补液量相比,差异无统计学意义(P>0.05),研究组术中瑞芬太尼及术后舒芬太尼用量均低于对照组(P<0.05);两组患者麻醉前的HR和心率(heart rate,HR)和平均动脉压(mean arterial pressure,MAP)相比,差异无统计学意义(P>0.05),研究组拔管时的HR及MAP均低于对照组(P<0.05);研究组术后4h、8h、12h及24h的VAS评分均低于对照组(P<0.05);研究组的不良反应发生率为10.00%,低于对照组的40.00%(P<0.05)。结论:胸横肌平面-胸神经阻滞联合喉罩全麻用于乳腺癌改良根治术效果良好,可以有效减少患者麻醉药物使用剂量,减轻患者术后的疼痛症状,且可以稳定患者的血流动力学,具有较好的安全性。Objective To analyze the application value of transverse pectoral muscle plane thoracic nerve block combined with laryngeal mask airway general anesthesia in modified radical surgery for breast cancer.Methods Forty patients with breast cancer who were to be treated by modified radical mastectomy in our hospital from January 2021 to January 2022 were selected and included in this study.They were randomly divided into the study group and the control group.The study group received transverse pectoral muscle plane thoracic nerve block combined with laryngeal mask anesthesia,and the control group received only laryngeal mask anesthesia.Hemodynamic indexes,pain scores and safety of the patients in the two groups were observed.Results There was no significant difference in surgical time,intraoperative bleeding,and intraoperative fluid replacement between the two groups of patients(P>0.05).The intraoperative and postoperative amounts of remifentanil in the study group were lower than those in the control group(P<0.05);There was no significant difference in heart rate(HR and mean arterial pressure(MAP)before anesthesia between the two groups of patients(P>0.05).The HR and MAP during extubation in the study group were lower than those in the control group(P<0.05);The VAS scores of the study group at 4 hours,8 hours,12 hours,and 24 hours after surgery were lower than those of the control group(P<0.05);The incidence of adverse reactions in the study group was 10.00%,lower than the control group’s 40.00%(P<0.05).Conclusions Thoracic transverse muscle plane thoracic nerve block combined with general anesthesia of laryngeal mask airway can be effectively used in modified radical mastectomy for breast cancer,which can effectively reduce the dosage of Narcotic used by patients,alleviate the postoperative pain symptoms of patients,and stabilize the hemodynamics of patients,with good safety.

关 键 词：胸横肌平面-胸神经阻滞 喉罩全麻 乳腺癌改良根治术 不良反应 

分 类 号：R737.9[医药卫生—肿瘤]