超声引导下胸部神经阻滞联合无背景剂量患者自控静脉镇痛对乳腺部分切除患者术后镇痛的疗效  

Effectiveness of ultrasound-guided pectoral nerve block combined with nobackground patient controlled intravenous analgesia inpostoperative pain control of partial mastectomy patients

作　　者：尤兰英 王品 王珏[1] 吴月雯 黄俊杰[1] 姜顺顺 王发武 朱淼 郑康[1] YOU Lanying;WANG Pin;WANG Jue;WU Yuewen;HUANG Junjie;JIANG Shunshun;WANG Fawu;ZHU Miao;ZHENG Kang(Department of Anesthesiology,Pukou Traditional Chinese Medicine Hospital Affiliated to China Pharmaceutical University,Nanjing,Jiangsu 211800,China;不详)

机构地区：[1]中国药科大学附属浦口中医院麻醉科,江苏南京211800 [2]南京一民医院麻醉科,江苏南京210000 [3]中国药科大学附属浦口中医院普外科,江苏南京211800

出　　处：《中国临床研究》2024年第8期1206-1209,共4页Chinese Journal of Clinical Research

基　　金：江苏省医学会麻醉医学科研专项资金项目[SYH-32021-0042(2021037)]。

摘　　要：目的 观察超声引导下胸部神经阻滞联合无背景剂量患者自控静脉镇痛(PCIA)用于乳腺部分切除患者术后镇痛的有效性和安全性。方法 选择中国药科大学附属浦口中医院2022年5月至2023年5月择期行乳腺部分切除的60例患者,随机分为M组和N组,各30例。患者术后均行无背景剂量PCIA,M组于术毕在超声引导下用0.2%罗哌卡因30 mL行胸壁神经阻滞术,N组不做其他处理。结局指标为离开复苏室时(T_0)、术后4 h(T_1)、术后12 h(T_2)、术后24 h(T_3)、术后48 h(T_4)静态及咳嗽时VAS评分,静脉镇痛用药总量及补救镇痛次数等。结果 T_0、T_1、T_2及T_3时点M组患者静态VAS评分显著低于N组(P<0.05),T_0、T_1和T_2时点M组患者咳嗽时VAS评分显著低于N组(P<0.05)。M组患者术后48 h PCIA按压次数、累计药物使用量显著低于N组(P<0.05)。两组患者术后不良反应发生率差异无统计学意义(P>0.05),M组未发生与神经阻滞相关的并发症。结论 超声引导下胸部神经阻滞联合无背景剂量PCIA能够有效减低乳腺部分切除患者术后疼痛,减少静脉镇痛药物用量。Objective To study the effectiveness and safety of ultrasound-guided pectoral nerve block combined with no background patient controlled intravenous analgesia(PCIA)in postoperative pain control of partial mastectomy patients.Methods A total of 60 patients who underwent elective partial mastectomy at Pukou Traditional Chinese Medicine Hospital Affiliated to China Pharmaceutical University from May 2022 to May 2023 were selected and divided into group M and group N,with 30 cases in each growp.Both groups received no background PCIA.Patients in M group received 0.2%ropivacaine 30 mL for pectoral nerve block,while patients in group N did not receive any other treatment.The outcome measures were VAS scores during static and coughing at the time point of patient leaving resuscitation room(T_(0)),4 hours(T_(1)),12 hours(T_(2)),24 hours(T_(3)),and 48 hours(T_(4))after surgery,as well as the total analgesia consumption and rescue analgesia dosage.Results Patients in group M showed a lower rest VAS at T_(0),T_(1),T_(2),and T_(3) time point(P<0.05),and lower cough VAS at T_(0),T_(1),and T_(2) time point than patients in group N(P<0.05).In group M,the total intravenous analgesia consumption and number of presses were significantly less than group N at 48 hours after surgery(P<0.05).There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups(P>0.05),and there was no complication related to nerve block in group M.Conclusion Ultrasound-guided pectoral nerve block combined with no background PCIA is able to provide potent postoperative pain control,reduce analgesia consumption in partial mastectomy patients.

关 键 词：超声引导 胸部神经阻滞 术后镇痛 乳腺部分切除术 无背景剂量 患者自控静脉镇痛 

分 类 号：R614.4[医药卫生—麻醉学]