超声引导下胸神经阻滞Ⅱ在乳腺癌根治手术中的镇痛价值

Analgesic Value of Pecs-ⅡGuided by Ultrasound in Radical Breast Cancer Surgery

【目的】探讨超声引导下胸神经阻滞Ⅱ(Pecs-Ⅱ)在乳腺癌根治手术中的镇痛价值。【方法】于本院接受治疗的84例乳腺癌根治手术患者随机分为两组,其中对照组42例,接受胸椎旁神经阻滞(TPVB),观察组42例,接受超声引导下胸神经阻滞Ⅱ(Pecs-Ⅱ),比较两组患者的手术时间、24 h内舒芬太尼用量、24 h视觉模拟评分(VAS)、心率、平均动脉压以及不良反应的发生率。【结果】观察组患者的平均手术时间为(122.14±12.03)min,与对照组的(135.27±13.26)min相比较差异无显著性(P>0.05)。观察组患者术后24 h内PCIA舒芬太尼用量、术后24 h VAS评分、心率和平均动脉压均优于对照组,且两组相比较差异均有显著性(P<0.05)。观察组患者恶心呕吐、镇痛过度、呼吸抑制等不良反应总发生率明显低于对照组,且两组比较差异有显著性(P<0.05)。【结论】超声引导下Pecs-Ⅱ能够有效提高乳腺癌根治手术妇女的镇痛价值,减少舒芬太尼用量,缓解疼痛,加强镇痛效果,保证心率血压维持在正常水平,降低不良反应的发生率,值得临床上推广。

【Objective】To explore the sedative value of ultrasound-guided thoracic nerve blockⅡ(Pecs-Ⅱ)in radical mastectomy of breast cancer.【Methods】A total of 84 patients with radical mastectomy due to breast cancer who were treated in our hospital were selected as subjects.All patients were randomly divided into two groups.Among them,42 patients in the control group received thoracic paravertebral nerve block(TPVB)and 42 patients in the observation group underwent ultrasound-guided thoracic nerve blockⅡ(Pecs-Ⅱ).The operation time,sufentanil dosage within 24 hours,24-hour VAS score,heart rate,mean arterial pressure and the incidence of adverse reactions were compared between the two groups.【Results】The average operation time of the observation group was 122.14±12.03 min,which was not significantly different from the control group's 135.27±13.26 min(P>0.05).The dosage of sufentanil for PCIA,the VAS score,heart rate and average arterial pressure 24 hours after surgery in the observation group were better than those in the control group.The difference was statistically significant(P<0.05).The incidence of adverse reactions such as nausea,vomiting,excessive analgesia,and respiratory depression in the observation group was lower than that in the control group.The difference between the two groups was statistically significant(P<0.05).【Conclusion】Ultrasound-guided Pecs-Ⅱcan effectively improve the analgesic value of women undergoing radical surgery for breast cancer,reduce the dosage of sufentanil,relieve pain,enhance analgesic effect,ensure heart rate and blood pressure well maintained at normal level,and reduce the incidence of adverse reactions.It is worth promoting in clinic.