菱形肌-肋间肌阻滞对乳腺癌患者术后应激和阿片类药物需求的影响  

Effects of rhomboid-intercostal block on postoperative stress and opioid requirements in patients with breast cancer

作　　者：张茂先 李健维 张莉 赵丽艳 于芝 宋阳 ZHANG Maoxian;LI Jianwei;ZHANG Li;ZHAO Liyan;YU Zhi;SONG Yang(Department of Anesthesiology,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院麻醉科,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第9期769-772,共4页Ningxia Medical Journal

摘　　要：目的探讨菱形肌-肋间肌阻滞对乳腺癌患者术后应激和阿片类药物需求的影响。方法选取拟行保乳术联合腋窝淋巴结清扫术(BCS-AD)的60例乳腺癌患者为研究对象。采用随机数字表法将其分为PECSⅡ组和RIB组,每组30例。PECSⅡ组患者采用Ⅱ型胸神经阻滞(PECSⅡ),RIB组患者采用菱形肌-肋间肌阻滞(RIB),术后比较2组患者不同时间点静息状态和活动状态疼痛评分、阿片类药物需求量及阻滞并发症发生率。结果RIB组患者不同时间点静息状态和活动状态疼痛评分均低于PECSⅡ组,但组间比较差异无统计学意义(P>0.05);术后阿片类需求量RIB组患者高于PECSⅡ组,但组间比较差异无统计学意义(P>0.05)。结论在乳腺癌BCS-AD治疗中,RIB组在降低患者术后疼痛应激及阿片类药物需求量方面与PECSⅡ组相当,且不增加患者术后阻滞相关并发症的发生率。Objective To investigate the effect of rhomboid-intercostal muscle block on postoperative stress and opioid demand in breast cancer patients.Methods A total of 60 breast cancer patients who planned to undergo breast-conserving surgery-axillary dissection(BCS-AD)were enrolled as research subjects.The patients were divided into PECS II group(n=30)and RIB group(n=30).The type II pectoral nerve block(PECSⅡ)was used in the PECSⅡgroup,and the rhomboid intercostal block(RIB)was used for the RIB group.The pain scores,opioid requirement and incidence of block complications of the two groups of patients at rest and in motion at different time points after surgery were compared.Results The pain scores of patients in RIB group were lower than those in PECSⅡgroup at different time points,but there was no significant difference between the two groups(P>0.05).The demand for opioids in RIB group was higher than that in PECSⅡgroup,but there was no significant difference between the two groups(P>0.05).Conclusion In the treatment of breast cancer BCS-AD,RIB is comparable to PECSⅡin reducing postoperative pain stress and opioid requirements,without increasing the incidence of postoperative blockade-related complications.

关 键 词：菱形肌-肋间肌阻滞 乳腺癌 术后应激 阿片类药 

分 类 号：R614[医药卫生—麻醉学]