Optimization strategy for anesthesia in modified radical mastectomy for breast cancer:Paravertebral nerve block combined with opioid-free gen-eral anesthesia
10.3969/j.issn.1009-9905.2025.02.004
- VernacularTitle:乳腺癌改良根治术麻醉的优化策略:胸椎旁神经阻滞-无阿片药麻醉
- Author:
Yong-zhi CHEN
1
;
Yu-jiao ZHANG
;
Bin SHI
;
Gui-juan WANG
;
Yuan LI
;
Ren-yi CHEN
Author Information
1. 山东省临沂市肿瘤医院麻醉科(山东 临沂 276000)
- Publication Type:Journal Article
- Keywords:
Breast cancer;
Paravertebral nerve block;
Opioid-free anesthesia;
Systemic immune inflammation index
- From:
Chinese Journal of Current Advances in General Surgery
2025;28(2):114-118
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to evaluate the application effect of opioid-free anesthesia(OFA)in modified radical mastectomy for breast cancer.Methods:80 patients undergoing unilateral modified radical mastec-tomy were randomly divided into two groups:general anesthesia group(G group)and OFA group(O group).The G group received general anesthesia with opioid drugs and a laryngeal mask,while the O group received general anes-thesia with intravenous lidocaine combined with thoracic paravertebral nerve block and a laryngeal mask.The average arterial pressure(MAP)and heart rate(HR)of the patients were recorded at the time of admission(T0),induction(T1),start of surgery(T2),gland resection(T3),and admission to the recovery room(T4).The surgical time,awakening time,ex-tubation time,and getting out of bed time were recorded.The VAS score at 2 hours(T5),6 hours(T6),and 12 hours(T7)after surgery,as well as the systemic immune-inflammatory index(SII)before surgery(T8),6 hours after surgery(T9),and 12 hours after surgery(T10)were recorded.The occurrence of postoperative nausea and vomiting(PONV)and post-mastectomy pain syndrome(PMPS)were recorded.The occurrence of adverse events such as poor nerve block effect,pneumothorax,hematoma,and local anesthetic toxicity were also recorded.Results:The MAP and HR of the O group were more stable than those of the G group during surgery(P＜0.05).The awakening time,extubation time,and getting out of bed time in the O group were earlier than those in the G group(P＜0.05).The VAS and SII values after surgery were significantly lower in the O group than in the G group(P＜0.05).The incidence of PONV was also signifi-cantly decreased(P＜0.05).In addition,no adverse events such as pneumothorax,hematoma,or local anesthetic toxic-ity occurred in the O group.Conclusion:Pioid-free anesthesia is safe and effective in modified radical mastectomy for breast cancer,shortening recovery time,time to first flatus,and time to ambulation,while alleviating postoperative pain,systemic inflammatory response,perioperative hemodynamic fluctuations,and the incidence of postoperative nau-sea and vomiting.
