超声引导下前锯肌平面和竖脊肌平面阻滞在乳腺癌根治术围术期的应用对比研究

A comparative study of ultrasound-guided serratus anterior plane and erector spinal plane block in the perioperative period of radical mastectomy for breast cancer

目的 比较超声引导下前锯肌平面和竖脊肌平面阻滞在乳腺癌根治术围术期的应用效果。方法 本次纳入对象为2017年10月~2021年10月收治的乳腺癌患者80例,拟行乳腺癌根治术,随机分成两组,各40例,分别采取超声引导下前锯肌平面(SAPB)和竖脊肌平面阻滞(ESPB),记录两组术后疼痛情况、镇痛镇静药物使用剂量、术后恢复相关指标及并发症情况。结果 术后2 h、24 h及48 h两组VAS评分比较差异无统计学意义(P> 0.05);两组丙泊酚、舒芬太尼及瑞芬太尼用量比较差异均无统计学意义(P> 0.05);两组术后进食时间、首次肛门排气时间、离床活动时间及住院时间比较差异均无统计学意义(P> 0.05);SPAB组不良反应发生率为47.5%,ESPB组为37.5%,比较差异无统计学意义(P> 0.05)。结论 乳腺癌根治术围术期中超声引导下ESPB与SAPB应用效果较好,镇痛效果与不良反应相当,临床可结合实际合理选择。

Objective To compare the effect of ultrasound-guided serratus anterior plane and erector spinal plane block in the perioperative period of radical mastectomy.Methods The subjects included were 80 breast cancer patients admitted to our hospital from October 2017 to October 2021.They were planned to undergo radical mastectomy.They were randomly divided into two groups,40 cases in each group,and was taken serratus anterior plane(SAPB) and erector spinal muscle plane block(ESPB) which by the ultrasound-guided.The postoperative pain,the dosage of analgesic and sedative drugs,postoperative recovery related indicators and complications were recorded in the two groups.Results There was no statistically significant difference in VAS scores between the two groups at 2 h,24 h and 48 h after operation(P > 0.05);there was no statistically significant difference between the two groups of propofol,sufentanil and remifentanil dosages(P > 0.05);There was no significant difference between the two groups in the time of eating,the time of first anal exhaust,the time of getting out of bed,and the length of stay in the two groups after surgery(P > 0.05);the incidence of adverse reactions in the SPAB group was 47.5%,and 37.5% in the ESPB group.The difference was not statistically significant(P > 0.05).Conclusion The perioperative ultrasound-guided application of ESPB and SAPB in radical mastectomy for breast cancer has a good effect,and the analgesic effect is equivalent to the adverse reactions,and the clinical practice can be combined with the actual choice.