Background: Pectoral nerves (PECS) block has been reported to be effective for a perioperative analgesia for breast cancer surgery. In addition, we may consider that the PECS block is also effective for motor function...Background: Pectoral nerves (PECS) block has been reported to be effective for a perioperative analgesia for breast cancer surgery. In addition, we may consider that the PECS block is also effective for motor function in postoperative period. Therefore, we investigated the effect of PECS block for motor function in postoperative period. Methods: This study selected the patients performed the breast cancer surgery between April and September, 2015. The study surveyed the difficulty of movement of the upper limbs at postoperative day 5 (D5) and postoperative month 6 (M6) by performing telephone survey. We counted the number of patients who complained of the difficulty of movement of the upper limbs. All results were compared using the chi- squared test. P < 0.05 was considered statistically significant. Results: 93 patients received only general anesthesia (G group). 85 patients received PECS block with general anesthesia (P group). The number of the P group at D5 was 2 patients. On the other hand, the number of the G group was 15 patients (P = 0.042). In the same way, the number of the P group M6 was no patient. On the other hand, the number of the G group was 10 patients (P = 0.043). Conclusion: A PECS block is effective for motor function recovery in the early postoperative period after breast cancer surgery.展开更多
Background and Aims: Pectoral nerve blocks gained increasing recognition for adequate postoperative pain relief following breast surgery. Traditionally, anaesthetist administered preoperatively under ultrasound guidan...Background and Aims: Pectoral nerve blocks gained increasing recognition for adequate postoperative pain relief following breast surgery. Traditionally, anaesthetist administered preoperatively under ultrasound guidance, which added significantly to the total procedure time. We studied the effectiveness of intraoperative direct vision pectoral nerve block and reduction of total theatre time. Methods: We provided questionnaires to the eligible patients who underwent a mastectomy and or axillary node clearance from August 2018 to May 2019. All the patients had an intra-operative pectoral 1 and serratus plane (Pecs) block. Participants documented pain score twice daily, episodes of nausea or vomiting and type and dose of analgesia for the first seven postoperative days. We compiled and grouped the results into postoperative days 1 - 2 and 3 - 7 for data analysis. Results: Patients reported generally low levels of pain, with a median pain score of 1.75 out of 10 for postoperative days 1 - 2 (IQR 4). The score decreased to 0.7 for days 3 - 7 postoperatively (IQR 3) suggesting that most patients had generally minimal levels of pain apart from a few outliers. The average injection time for PECs blocks was 5 minutes, significantly less than USS guided techniques of 20 - 30 minutes. Conclusions: Our data suggest that nerve blocks under direct vision offer satisfactory efficacy in postoperative analgesia with minimal nausea and vomiting. This is in addition to substantial benefits in operative efficiency and reduction of total procedure time.展开更多
目的:肱骨髁上骨折是儿童肘部骨折中最常见的类型,对于移位的肱骨髁上骨折,闭合复位固定是首选的治疗方案,但是对于选择合适的技术仍存在分歧。因而,此次荟萃分析旨在评估单侧和双侧交叉钉固定对儿童肱骨髁上骨折的疗效,为临床治疗提供...目的:肱骨髁上骨折是儿童肘部骨折中最常见的类型,对于移位的肱骨髁上骨折,闭合复位固定是首选的治疗方案,但是对于选择合适的技术仍存在分歧。因而,此次荟萃分析旨在评估单侧和双侧交叉钉固定对儿童肱骨髁上骨折的疗效,为临床治疗提供参考。方法:全面检索PubMed、Embase、Web of Science和the Cochrane Library建库以来至2023-01-06发表的相关随机对照试验,比较儿童肱骨髁上骨折内外侧交叉固定和单纯外侧固定两种术式的疗效差异,主要观察指标是影像学结果(Baumann角丢失、提携角丢失)、肘关节功能和常见并发症(医源性尺神经损伤、针道感染)。结果:①共纳入18项研究;②两组Baumann角丢失(P=0.47)、提携角丢失(P=0.47)情况相比无统计学差异;外侧固定组与内外侧交叉固定组关节功能恢复评分优秀的患儿比例分别为70.7%和74.9%,差异无显著性意义(P=0.12);两组在针道感染发生率上同样无统计学差异(P=0.9),但内外侧交叉固定组医源性尺神经损伤的风险更高(P=0.02);③然而,当采用小切口联合探查时,内外侧交叉固定组尺神经损伤的频率与外侧固定组相比无统计学差异(P=0.2);④在GartlandⅢ型亚组中,两组在关节功能恢复评分优秀率(P=0.13)、尺神经损伤(P=0.13)和针道感染(P=0.61)方面均无统计学差异。结论:荟萃分析结果显示,与外侧固定技术相比,内外侧交叉固定方法更容易造成前臂的医源性神经损伤,但同时也增加了结构的稳定性。不过,通过小切口方法联合内外侧交叉固定似乎可以降低患者神经损伤的风险。因此,儿童肱骨髁上骨折治疗采用小切口结合内外侧交叉固定可能是一种既保证结构稳定、又安全的固定方法。展开更多
目的探讨超声引导下胸壁神经阻滞在经腋窝入路腔镜甲状腺手术患者围术期镇痛效果及术后恢复的影响,并评估其有效性和安全性。方法选取60例接受经腋窝腔镜甲状腺手术患者,按照随机数字表法分为两组:超声引导下胸壁神经阻滞复合全身麻醉...目的探讨超声引导下胸壁神经阻滞在经腋窝入路腔镜甲状腺手术患者围术期镇痛效果及术后恢复的影响,并评估其有效性和安全性。方法选取60例接受经腋窝腔镜甲状腺手术患者,按照随机数字表法分为两组:超声引导下胸壁神经阻滞复合全身麻醉组(P组)和单纯全身麻醉组(C组),每组30例。P组在超声引导下行PecsⅠ联合PecsⅡ阻滞后,两组患者均接受气管插管下的全身麻醉,比较两组患者的围手术期镇痛效果和术后恢复情况。结果在围术期镇痛效果方面,P组患者在术中舒芬太尼使用量、术后补救镇痛次数及补救镇痛时酮咯酸氨丁三醇使用量均明显低于C组(P<0.05),在术后3、6、12 h,P组患者静息及运动状态下的NRS评分也显著低于C组(P<0.05);在术后恢复质量方面,P组患者苏醒时间、PACU停留时间明显短于C组(P<0.05),术后24 h QoR-40量表评分总分及身体舒适度、疼痛维度评分均高于C组(P<0.05)。结论超声引导下胸壁神经阻滞在经腋窝腔镜甲状腺手术中展现出良好的镇痛效果,且有助于患者的术后恢复。展开更多
文摘Background: Pectoral nerves (PECS) block has been reported to be effective for a perioperative analgesia for breast cancer surgery. In addition, we may consider that the PECS block is also effective for motor function in postoperative period. Therefore, we investigated the effect of PECS block for motor function in postoperative period. Methods: This study selected the patients performed the breast cancer surgery between April and September, 2015. The study surveyed the difficulty of movement of the upper limbs at postoperative day 5 (D5) and postoperative month 6 (M6) by performing telephone survey. We counted the number of patients who complained of the difficulty of movement of the upper limbs. All results were compared using the chi- squared test. P < 0.05 was considered statistically significant. Results: 93 patients received only general anesthesia (G group). 85 patients received PECS block with general anesthesia (P group). The number of the P group at D5 was 2 patients. On the other hand, the number of the G group was 15 patients (P = 0.042). In the same way, the number of the P group M6 was no patient. On the other hand, the number of the G group was 10 patients (P = 0.043). Conclusion: A PECS block is effective for motor function recovery in the early postoperative period after breast cancer surgery.
文摘Background and Aims: Pectoral nerve blocks gained increasing recognition for adequate postoperative pain relief following breast surgery. Traditionally, anaesthetist administered preoperatively under ultrasound guidance, which added significantly to the total procedure time. We studied the effectiveness of intraoperative direct vision pectoral nerve block and reduction of total theatre time. Methods: We provided questionnaires to the eligible patients who underwent a mastectomy and or axillary node clearance from August 2018 to May 2019. All the patients had an intra-operative pectoral 1 and serratus plane (Pecs) block. Participants documented pain score twice daily, episodes of nausea or vomiting and type and dose of analgesia for the first seven postoperative days. We compiled and grouped the results into postoperative days 1 - 2 and 3 - 7 for data analysis. Results: Patients reported generally low levels of pain, with a median pain score of 1.75 out of 10 for postoperative days 1 - 2 (IQR 4). The score decreased to 0.7 for days 3 - 7 postoperatively (IQR 3) suggesting that most patients had generally minimal levels of pain apart from a few outliers. The average injection time for PECs blocks was 5 minutes, significantly less than USS guided techniques of 20 - 30 minutes. Conclusions: Our data suggest that nerve blocks under direct vision offer satisfactory efficacy in postoperative analgesia with minimal nausea and vomiting. This is in addition to substantial benefits in operative efficiency and reduction of total procedure time.
文摘目的:肱骨髁上骨折是儿童肘部骨折中最常见的类型,对于移位的肱骨髁上骨折,闭合复位固定是首选的治疗方案,但是对于选择合适的技术仍存在分歧。因而,此次荟萃分析旨在评估单侧和双侧交叉钉固定对儿童肱骨髁上骨折的疗效,为临床治疗提供参考。方法:全面检索PubMed、Embase、Web of Science和the Cochrane Library建库以来至2023-01-06发表的相关随机对照试验,比较儿童肱骨髁上骨折内外侧交叉固定和单纯外侧固定两种术式的疗效差异,主要观察指标是影像学结果(Baumann角丢失、提携角丢失)、肘关节功能和常见并发症(医源性尺神经损伤、针道感染)。结果:①共纳入18项研究;②两组Baumann角丢失(P=0.47)、提携角丢失(P=0.47)情况相比无统计学差异;外侧固定组与内外侧交叉固定组关节功能恢复评分优秀的患儿比例分别为70.7%和74.9%,差异无显著性意义(P=0.12);两组在针道感染发生率上同样无统计学差异(P=0.9),但内外侧交叉固定组医源性尺神经损伤的风险更高(P=0.02);③然而,当采用小切口联合探查时,内外侧交叉固定组尺神经损伤的频率与外侧固定组相比无统计学差异(P=0.2);④在GartlandⅢ型亚组中,两组在关节功能恢复评分优秀率(P=0.13)、尺神经损伤(P=0.13)和针道感染(P=0.61)方面均无统计学差异。结论:荟萃分析结果显示,与外侧固定技术相比,内外侧交叉固定方法更容易造成前臂的医源性神经损伤,但同时也增加了结构的稳定性。不过,通过小切口方法联合内外侧交叉固定似乎可以降低患者神经损伤的风险。因此,儿童肱骨髁上骨折治疗采用小切口结合内外侧交叉固定可能是一种既保证结构稳定、又安全的固定方法。
文摘目的探讨超声引导下胸壁神经阻滞在经腋窝入路腔镜甲状腺手术患者围术期镇痛效果及术后恢复的影响,并评估其有效性和安全性。方法选取60例接受经腋窝腔镜甲状腺手术患者,按照随机数字表法分为两组:超声引导下胸壁神经阻滞复合全身麻醉组(P组)和单纯全身麻醉组(C组),每组30例。P组在超声引导下行PecsⅠ联合PecsⅡ阻滞后,两组患者均接受气管插管下的全身麻醉,比较两组患者的围手术期镇痛效果和术后恢复情况。结果在围术期镇痛效果方面,P组患者在术中舒芬太尼使用量、术后补救镇痛次数及补救镇痛时酮咯酸氨丁三醇使用量均明显低于C组(P<0.05),在术后3、6、12 h,P组患者静息及运动状态下的NRS评分也显著低于C组(P<0.05);在术后恢复质量方面,P组患者苏醒时间、PACU停留时间明显短于C组(P<0.05),术后24 h QoR-40量表评分总分及身体舒适度、疼痛维度评分均高于C组(P<0.05)。结论超声引导下胸壁神经阻滞在经腋窝腔镜甲状腺手术中展现出良好的镇痛效果,且有助于患者的术后恢复。
