摘要
目的分析超声引导下前锯肌平面阻滞对乳腺癌手术后疼痛综合征的预防效果。方法选取2020年12月至2022年11月期间南阳市中心医院收治的乳腺癌术后患者总共102例进行研究,经随机数表法分成对照组(全身麻醉)、观察组(超声引导下前锯肌平面阻滞)各有51例。观察两组术后不同时间点的视觉模拟量表(VAS)得分;围术期镇静以及镇痛药物应用情况;手术前后丙二醛(MDA)、超氧化物歧化酶(SOD)、髓过氧化酶(MPO)、白介素-6(IL-6)、白介素-10(IL-10)、白介素-18(IL-18)及肿瘤坏死因子-α(TNF-α)水平;术后1个月、术后3个月及术后6个月疼痛综合征出现情况。结果观察组术后1 h、术后2 h、术后4 h、术后8 h、术后24 h的VAS得分低于对照组,差异有统计学意义(P<0.05)。观察组术中瑞芬太尼、丙泊酚使用量及术后舒芬太尼使用量低于对照组,差异有统计意义(P<0.05),术后首次按压时间长于对照组,差异有统计意义(P<0.05),48 h内有效按压次数少于对照组,差异有统计意义(P<0.05)。术前,两组MDA、SOD、MPO、IL-6、IL-10、IL-18及TNF-α水平相比,差异无统计学意义(P>0.05);术后,观察组MDA、SOD、MPO、IL-6、IL-10、IL-18及TNF-α水平低于对照组,差异有统计意义(P<0.05)。观察组术后1个月、术后3个月及术后6个月的疼痛综合征占比低于对照组,差异有统计意义(P<0.05)。结论超声引导下前锯肌平面阻滞对乳腺癌手术后疼痛综合征预防效果理想,能减轻患者术后的疼痛感、氧化应激反应以及炎症反应,减少围术期镇静以及镇痛药物使用,值得采用。
Objective To analyze the effect of plane block of the anterior serratus muscle guided by ultrasound on the prevention of pain syndrome after breast cancer surgery.Methods From December 2020 to November 2022,a total of 102 patients with breast cancer who were treated in Nanyang Central Hospital after surgery were selected for the study.They were divided into control group(general anesthesia)and observation group(Plane block of saw anterior muscle guided by ultrasound)according to the random number table,with 51 cases in each group.The visual analogue scale(VAS)scores of two groups at different postoperative time points and the application of sedative and analgesic drugs during the perioperative period were observed;The level of malondialdehyde(MDA),superoxide dismutase(SOD),myeloperoxidase(MPO),interleukin-6(IL-6),interleukin-10(IL-10),interleukin-18(IL-18),and tumor necrosis factor-α(TNF-α)before and after surgery were analyzed;The occurrence of pain syndrome 1 month,3 months,and 6 months after surgery were analyzed.Results The VAS scores of the observation group at 1 hour,2 hours,4 hours,8 hours,and 24 hours after surgery were lower than those of the control group,with a statistically significant difference(P<0.05).The intraoperative use of remifentanil,propofol,and postoperative use of sufentanil in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The first press time after surgery was longer than that in the control group,with statistically significant differences(P<0.05).The effective press frequency within 48 hours was less than that in the control group,with statistically significant differences(P<0.05).Before surgery,there was no significant difference in MDA,SOD,MPO,IL-6,IL-10,IL-18 and TNF-α levels between the two groups(P>0.05);After surgery,The level of MDA,SOD,MPO,IL-6,IL-10,IL-18,and TNF-α in the observation group was lower than those in the control group,and the difference was statistically significant(P<0.05).The proportion of pain syndrome in the observation group at 1 month,3 months,and 6 months after surgery was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Plane block of the anterior serratus muscle guided by ultrasound has an ideal effect on the prevention of pain syndrome after breast cancer surgery.It can reduce postoperative pain,oxidative stress and inflammatory reaction,and reduce perioperative sedation and analgesic drug use.
作者
刘明
朱新建
张浩
姜开洋
郭彬彬
LIU Ming;ZHU Xinjian;ZAHNG Hao;JIANG Kaiyang;GUO Binbin(Pain Department,Nanyang Central Hospital,Nanyang Henan 473000,China;Department of Breast Surgery,Nanyang Central Hospital,Nanyang Henan 473000,China)
出处
《临床研究》
2023年第12期46-49,共4页
Clinical Research
关键词
超声
前锯肌平面阻滞
乳腺癌根治术
疼痛综合征
ultrasound
anterior serratus muscle plane block
radical mastectomy for breast cancer
pain Syndrome
作者简介
刘明,女,住院医师,硕士研究生。研究方向:乳腺癌、甲状腺癌术后镇痛方面。
