超声引导下前锯肌平面阻滞与Ⅱ型胸神经阻滞在全麻乳腺癌根治术中的应用  

Application of ultrasound-guided anterior serratus plane block and typeⅡthoracic nerve block in general anesthesia for radical surgery for breast cancer

作　　者：刘欣[1] LIU Xin(Department of Surgery Anesthesiology,Zibo Maternal and Child Health Hospital,Shandong Province,Zibo 255000,China)

机构地区：[1]山东省淄博市妇幼保健院手术麻醉科,山东淄博255000

出　　处：《妇儿健康导刊》2025年第8期93-97,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的观察超声引导下前锯肌平面阻滞与Ⅱ型胸神经阻滞在全麻乳腺癌根治术中的应用效果。方法选取淄博市妇幼保健院2023年1月至2024年1月收治的70例全麻乳腺癌根治术患者,按照随机数字表法分为对照组与观察组,各35例。对照组麻醉前不进行神经阻滞,观察组麻醉前实施超声引导下前锯肌平面阻滞与Ⅱ型胸神经阻滞。比较两组入室时(T0)、术中(T1)、手术结束(T2)、术后1 h(T3)的Ramsay镇静评分,术前、术后6、12、24h的疼痛情况[视觉模拟评分法(VAS)],苏醒时间、拔管时间及不良反应发生情况。结果T0、T3,两组Ramsay镇静评分比较,差异无统计学意义(P>0.05)。T1、T2,观察组Ramsay镇静评分高于对照组(P<0.05)。两组苏醒时间、拔管时间比较,差异无统计学意义(P>0.05)。术后6、12、24 h,观察组VAS评分均较对照组低(P<0.05)。术后12 h,两组VAS评分均较术前、术后6 h低(P<0.05)。术后24 h,两组VAS评分均较术前、术后6 h、术后12 h低(P<0.05)。观察组不良反应总发生率较对照组更低(P<0.05)。结论在全麻乳腺癌根治术中实施超声引导下前锯肌平面与Ⅱ型胸神经阻滞具有较积极的效果,可有效促进术中镇静效果,改善疼痛,减少不良反应发生。Objective To observe the application effect of ultrasound-guided anterior serratus plane block and typeⅡthoracic nerve block in general anesthesia for radical surgery for breast cancer.Methods A total of 70 patients with general anesthesia for radical mastectomy for breast cancer admitted to Zibo Maternal and Child Health Hospital from January 2023 to January 2024 were selected and divided into the control group and the observation group according to the random number table method,with 35 cases in each group.The control group did not receive nerve block before anesthesia,and the observation group received ultrasound-guided anterior serratus plane block and typeⅡthoracic nerve block before anesthesia.The Ramsay sedation scores at the time of entry(T0),during surgery(T1),at the end of surgery(T2),and 1 hour after surgery(T3),pain level(visual analogue scale[VAS])before surgery and postoperative 6,12,and 24 hours,awakening time,extubation time,and incidence of adverse reactions were compared between the two groups.Results There were no statistically significant differences in Ramsay sedation scores between the two groups at T0 and T3(P>0.05).At T1 and T2,the Ramsay sedation scores in the observation group were higher than those in the control group(P<0.05).There was no statistically significant difference in awakening time and extubation time between the two groups(P>0.05).After 6,12,and 24 hours postoperatively,the VAS scores in the observation group were lower than those in the control group(P<0.05).At 12 hours postoperatively,both groups had lower VAS scores compared to before surgery and postoperative 6 hours(P<0.05).At 24 hours postoperatively,both groups had lower VAS scores compared to before surgery,postoperative 6 hours,and postoperative 12 hours(P<0.05).The total incidence of adverse reactions in the observation group was l ower than that in the control group(P<0.05).Conclusion The ultrasound-guided anterior serratus plane block and typeⅡthoracic nerve block in general anesthesia for breast cancer fo

关 键 词：前锯肌平面阻滞 Ⅱ型胸神经阻滞 全身麻醉 乳腺癌根治术 

分 类 号：R614[医药卫生—麻醉学]