不同区域阻滞技术在乳腺癌根治术中的应用进展

Application progress of different regional block techniques in radical mastectomy of breast cancer

乳腺癌是女性最常见的恶性肿瘤。由于乳腺区域神经支配复杂,如果术后急性疼痛处理不当,就有发展为慢性疼痛的风险。区域阻滞技术被认为是减少术后急性疼痛和慢性疼痛发生率的最佳选择。几种不同区域阻滞技术均被证明可以有效控制乳腺癌患者术后疼痛、降低阿片类药物用量及降低全麻并发症。超声引导下区域阻滞技术包括胸椎旁神经阻滞、胸神经阻滞、前锯肌平面阻滞、竖脊肌平面阻滞和菱形肋间肌平面阻滞均可用于乳腺癌术后镇痛。因此,这篇综述的目的是分析不同区域阻滞方法的解剖特点、阻滞技术及临床应用,为研究不同区域阻滞技术在乳腺癌根治术中的应用提供依据。

Breast cancer is the most common malignant tumor in women.Due to the complex innervation of the breast area,there is a risk of developing chronic pain if acute pain is not managed properly after surgery.Regional block techniques are considered to be the best option for reducing the incidence of postoperative acute and chronic pain.Several different regional block techniques have been proven to be effective in controlling postoperative pain,reducing opioid dosage and reducing general anesthesia complications in breast cancer patients.Ultrasound-guided regional block including thoracic paraspinal nerve block,thoracic nerve block,serratus anterior plane block,erector spinal plane block and rhomboid intercostal plane block can be used for postoperative analgesia of breast cancer.Therefore,the purpose of this review is to analyze the anatomical characteristics,block techniques and clinical application of different regional block techniques,and to provide a basis for the study of the application of different regional block techniques in radical mastectomy of breast cancer.