超声引导胸椎旁神经阻滞对乳腺癌根治术后疼痛的影响

目的 分析超声引导下胸椎旁神经阻滞对乳腺癌根治术后慢性疼痛的影响。方法 选择2018年1月~2019年1月在我院行乳腺癌根治术的患者70例，采用随机数字表法分为对照组和观察组，各35例。对照组直接诱导麻醉，观察组在麻醉诱导前行超声引导下胸椎旁神经阻滞。比较两组患者苏醒时间、术后镇痛药使用量、术后苏醒即刻、6、12、24 h疼痛（VAS）评分以及不良反应（恶心、呕吐、呼吸抑制、瘙痒）发生情况。结果 观察组苏醒时间、术后镇痛药使用量均低于对照组，差异有统计学意义（P＜0.05）；观察组术后苏醒即刻、6、12、24 h的VAS评分均低于对照组，差异有统计学意义（P＜0.05）；观察组不良反应发生率为11.42%，低于对照组的14.28%，但差异无统计学意义（P＞0.05）。结论 超声引导下胸椎旁神经阻滞可降低乳腺癌根治术后患者疼痛程度，减少镇痛药用量，且不会增加不良反应，应用效果良好。

Effect of Ultrasound-guided Thoracic Paravertebral Nerve Block on Pain after Radical Mastectomy for Breast Cancer

Objective To analyze the effect of ultrasound-guided thoracic paravertebral nerve block on chronic pain after radical mastectomy. Methods 70 patients with radical mastectomy in our hospital from January 2018 to January 2019 were enrolled. The patients were divided into the control group and the observation group by random number table, 35 cases each. The control group directly induced anesthesia, and the observation group underwent ultrasound-guided thoracic paravertebral nerve block before induction of anesthesia. The recovery time, postoperative analgesic use, immediate postoperative recovery, 6, 12, 24 h pain (VAS) score, and adverse reactions (nausea, vomiting, respiratory depression, itching) were compared between the two groups. Results The recovery time of the observation group and the postoperative analgesic use were lower than the control group, the difference was statistically significant (P<0.05). The VAS scores of the observation group immediately after recovery, 6, 12, 24 h were lower than the control group,the difference was statistically significant (P<0.05). The incidence of adverse reactions was 11.42% in the observation group, which was lower than 14.28% in the control group, but the difference was not statistically significant (P>0.05). Conclusion Ultrasound-guided thoracic paravertebral nerve block can reduce the pain level of patients after radical mastectomy, reduce the amount of analgesic medication, and will not increase the adverse reactions, and the application effect is good.