超声引导胸肌筋膜平面阻滞在乳腺癌手术中的研究进展

Research advances of ultrasound-guided thoracic muscle fascial plane block in breast cancer surgery

乳腺癌是女性最常见的肿瘤,手术是治疗乳腺癌的主要手段。ERAS理念的提出丰富了医学人文关怀的内容,其核心内容之一是围手术期的镇痛管理,多模式镇痛通过干预多层面的痛觉感知或传导,实现不同作用机制药物或镇痛方法的累加或协同,以减少阿片类药物的应用,超声引导区域阻滞已成为多模式镇痛的重要组成部分。本文详细阐述了乳腺周围的神经分布和常用的胸肌筋膜平面阻滞操作方法,比较胸肌筋膜平面阻滞与椎旁神经阻滞、竖脊肌平面阻滞的临床效果及并发症,重点介绍胸肌筋膜平面阻滞的改良方法,并探讨超声引导下不同的胸肌筋膜平面阻滞在乳腺手术中的应用前景。

Breast cancer is the most common tumor in women,and surgery is the main treatment for breast cancer.ERAS concept proposed to enrich the content of the medical humanities concern,and one of its core content is perioperative pain management.By intervening in the multifaceted pain perception or conduction,multimodal analgesia implements different mechanism of action of drugs or analgesia accumulation or together,in order to reduce the application of opioids,ultrasound-guided regional anesthesia has become an important component of the multimodal analgesia.This article in detail elaborated the nerve distribution around the mammary gland and commonly used chest muscle fascia plane block operation method;comparing the clinical effects and complications of chest muscle fascia plane block,vertebral nerve block,and erector spinae plane block;and this paper mainly introduces the improvement of chest muscle fascia plane block method,and to explore the application prospects of ultrasound guided by different pectoral muscle fascia plane block in breast surgery.