Efficacy of ultrasound-guided pectoral nerve block versus thoracic paravertebral block for postoperative analgesia after radical mastectomy
10.12089/jca.2018.02.005
- VernacularTitle:超声引导下胸神经阻滞和胸椎旁神经阻滞用于乳腺癌根治术后镇痛效果的比较
- Author:
Hongxu JIN
1
;
Tongjun ZHANG
;
Xuefei SUN
;
Zhongyi WANG
;
Fuchao WANG
Author Information
1. 河北医科大学附属哈励逊国际和平医院麻醉科
- Keywords:
Postoperative analgesia;
Pectoral nerve block;
Paravertebral nerve block;
Modified radical mastectomy
- From:
The Journal of Clinical Anesthesiology
2018;34(2):126-129
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and safety of ultrasound guided pectoral nerves Ⅱ (Pecs Ⅱ) block with thoracic paravertebral nerve (TPVN) block for postoperative analgesia after modified radical mastectomy.Methods Eighty female patients scheduled for radical mastectomy,aged 40-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups using a random number table method (n =40 each):the patients in group T received TPVN block,whereas the pa tients in group P received Pecs Ⅱ block.Both the groups received 0.5 ％ ropivacaine 25 ml.The blocks were performed under all aseptic precautions in the preoperating room 30 min before surgery.The total number of dermatomes that had less pain to pin prick compared with opposite side were not ed.All patients were observed for 30 min after performing the block.The patients were received patient-controlled intravenous analgesia (PCIA).The duration of analgesia and total analgesic consumption in 24 h after surgery were recorded.Adverse effects were recorded between the two groups.Results The duration of analgesia in group P was significantly prolonged than group T [(326.5± 47.8) min vs (201.4±34.5) min,P＜0.01].The 24 h sufentanil consumption were also decreased in group P [(6.9±1.2) μg vs (10.7±1.9) μg,P＜0.01].T2 dermatomal spread were significantly increased in group P [35 (87.6％) cases vs 9 (22.5％) cases,P＜0.05].No complication was recor ded.Conclusion Ultrasound-guided Pecs Ⅱ block and TPVN provided safe and effective anesthesia in patients undergoing modified radical mastectomy,but the effect of Pecs Ⅱ block were more satisfied and per sistent.
