胸椎旁神经阻滞对预防乳腺癌术后慢性疼痛影响的Meta分析

Meta-analysis of the Effect of Paravertebral Nerve Block on the Prevention of Chronic Pain After Breast Cancer Surgery

目的评估胸椎旁神经阻滞是否可以预防乳腺癌术后慢性术后疼痛的发生。方法分别检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网、维普网(VIP)、万方数据知识服务平台和中国生物医学文献数据库等数据库中检索查阅胸椎旁神经阻滞干预后是否可预防乳腺癌术后慢性术后疼痛发生的随机对照试验,并进行Meta分析。结果共纳入了16项研究,Meta分析结果显示,胸椎旁神经阻滞可减少乳腺癌术后3个月(OR=0.42,95%CI:0.32~0.5,P<0.00001)、6个月(OR=0.41,95%CI:0.31~0.54,P<0.00001)、12个月(OR=0.31,95%CI:0.2~0.49,P<0.00001)疼痛的发生。结论胸椎旁神经阻滞可有效降低乳腺癌术后慢性术后疼痛的发生,但由于纳入的文献样本量小,质量较低,今后仍需要高质量大样本的研究来验证。

Objective To evaluate whether thoracic paravertebral block can prevent chronic postoperative pain after breast cancer surgery.Methods PubMed,EMbase,Cochrane Library,Web of Science,CNKI,VIP,Wanfang Data Knowledge Service Platform and Chinese Biomedical Literature Database were searched for randomized controlled trials(RCTs)about whether thoracic paravertebral block intervention can prevent chronic postoperative pain after breast cancer surgery,and Meta-analysis was performed.Results A total of 16 studies were included.Meta-analysis showed that thoracic paravertebral block significantly reduced the incidence of pain at 3 months(OR=0.42,95%CI:0.32-0.5,P<0.00001),6 months(OR=0.41,95%CI:0.31-0.54,P<0.00001)and 12 months(OR=0.31,95%CI:0.2-0.49,P<0.00001)after breast cancer surgery.Conclusion Use of thoracic paravertebral block can effectively reduce the incidence of chronic post-surgical pain Paravertebral nerve block can effectively reduce the occurrence of chronic postoperative pain after breast cancer surgery.However,due to the small sample size and low quality of the included literature,high-quality large sample studies are still needed to verify it in the future.