超声引导下前锯肌阻滞对乳腺癌患者术后恢复质量的影响

Efficacy of ultrasound-guided serratus plane block on postoperative recovery quality undergoing modified radical mastectomy

目的评价超声引导下前锯肌阻滞对乳腺癌改良根治术患者术后早期恢复质量的影响。方法选择乳腺癌改良根治术患者61例,随机分为观察组30例和对照组31例。全身麻醉前,观察组超声引导下行单次前锯肌阻滞,共注射0.5%罗哌卡因25mL;对照组接受超声检查未行神经阻滞。主要观察指标为患者术后24h恢复质量(QoR-40量表),次要观察指标包括术中和术后阿片药物用量、苏醒时间、麻醉恢复室(PACU)停留时间、术后24h疼痛评分、恶心呕吐等不良反应发生率以及患者满意度。结果与对照组比较,观察组术后24h恢复质量好,术中和术后舒芬太尼用量减少,麻醉苏醒时间和PACU时间缩短,术后1、48hNRS疼痛评分较低,患者满意度评分较高。结论超声引导下前锯肌阻滞可以提高乳腺癌患者改良根治术后早期恢复质量。

Objective To examine the effect of ultrasound-guided serratus plane block(SPB)on the early postoperative quality of recovery undergoing modified radical mastectomy undergoing general anesthesia.Methods Sixty-one American society of anesthesiologistsphysical status(ASA)ⅠorⅡ patients undergoing modified radical mastectomy were randomly allocated to the observation group 30 cases or control group 31 cases.The observation group received single-injection of SPB with 25 mL of0.5% ropivacaine,whereas the control group received no SPB before anesthesia induction.The primary outcome was the quality of recovery,which was assessed at 24 hours after surgery using the quality of recovery 40 questionnaire(QoR-40).Secondary outcomes included intraoperative and postoperative opioid consumption,the incidence of postoperative nausea or vomiting(PONV),and patient satisfaction.Results Global QoR-40 score at 24 hours following surgery was higher in the observation group than that in the control group.Intraoperative and postoperative sufentanil consumption was lower in the observation group compared with the control group.Simultaneously,NRS scores for pain at postoperative 1 st,4 th,and 8 th hour were lower in the observation group.Preoperative SPB also shortened the emergence time and the duration of PACU stay and improved the patients satisfaction scores.Conclusion Preoperative SPB can enhance the quality of recovery and the patients satisfaction undergoing general anesthesia for modified radical mastectomy.