胸部神经阻滞联合全身麻醉在乳腺癌改良根治术中的应用

目的探讨胸部神经阻滞(PECS)联合全身麻醉在乳腺癌改良根治术中的临床价值。方法选取2017年1月至2019年11月于本院治疗的乳腺癌患者92例,均行乳腺癌改良根治术,根据麻醉方式分为观察组(n=41)和对照组(n=51)。对照组给予全身麻醉,观察组在对照组基础上给予PECS,比较两组手术时间、术后苏醒时间、瑞芬太尼用量、不同时间点VAS评分及不良反应发生率。结果观察组术后苏醒时间短于对照组,瑞芬太尼用量少于对照组(P<0.05);两组手术时间比较差异无统计学意义。术后T₀~T₃时间点,观察组VAS评分低于对照组,差异有统计学意义(P<0.05);两组患者术后T₀~T₃时间点组间和时间交互效应比较差异有统计学意义(P<0.05)。观察组恶心呕吐、头晕发生率明显低于对照组(P<0.05);两组术中低血压、皮肤瘙痒发生率比较差异无统计学意义。结论PECS联合全身麻醉用于乳腺癌改良根治术临床效果显著,能减轻患者疼痛程度,缩短患者苏醒时间,值得临床推广。

Application of thoracic nerve block combined with general anesthesia in modified radical mastectomy for breast cancer

Objective To explore the clinical value of thoracic nerve block(PECS)combined with general anesthesia in modified radical mastectomy for breast cancer.Methods A total of 92 breast cancer patients treated in our hospital from January 2017 to November 2019 were selected and modified radical mastectomy was performed in our hospital.They were divided into observation group(n=41)and control group(n=51)according to the way of anesthesia.The control group was given general anesthesia,and the observation group was given PECS on the basis of the control group.The operation time,postoperative recovery time,remifentanil dosage,VAS score at different time points and the incidence of adverse reactions were compared between the two groups.Results The postoperative recovery time of the observation group was shorter than that of the control group,and the dosage of remifentanil was less than that of the control group(P<0.05);there was no significant difference in operation time between the two groups.The VAS score of the observation group was significantly lower than that of the control group at T₀-T₃ time points after operation(P<0.05);there was significant difference in time interaction effect between the two groups at T₀-T₃ time point(P<0.05).The incidence of nausea,vomiting and dizziness in the observation group was significantly lower than that in the control group(P<0.05);there was no significant difference in the incidence of intraoperative hypotension and skin pruritus between the two groups.Conclusion PECS combined with general anesthesia for modified radical mastectomy for breast cancer has good clinical effect,it can reduce the degree of pain and shorten the recovery time of patients,which is worthy of clinical promotion.