浸润镇痛与胸神经阻滞治疗乳腺癌乳房切除术后疼痛的比较

G. Argun, İ. Kaya, S. Ünver
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摘要

在本研究中,我们旨在比较浸润镇痛和胸神经阻滞方法在肿瘤乳房切除术后患者疼痛评分、阿片类药物总消耗和麻醉后护理单位(PACU)出院时间方面的优势。方法:经伦理委员会批准和患者同意后,纳入60例年龄在18-80岁之间接受乳腺癌乳房切除术的患者。患者分为两组,第一组采用胸神经阻滞术后镇痛,第二组采用浸润镇痛。术中应用替诺昔康20mg。术后第1、6、12、24小时采用视觉模拟Scala (VAS)评价疼痛。VAS大于3分的患者给予曲马多1 mg/kg,必要时给予吗啡(05-1 mg)。记录患者术后24小时内镇痛药总用量、PACU出院时间、恶心、呕吐等不良反应发生率,并对结果进行统计学评价。结果:两组患者人口学特征相似。术后第1、6、12、24小时胸神经阻滞组VAS评分明显低于浸润镇痛组。胸神经阻滞组镇痛总用量、恶心呕吐率及PACU出院时间均显著低于对照组。讨论与结论:在我们的研究中,胸神经阻滞法在肿瘤乳房手术后疼痛处理上优于浸润镇痛法。总之,我们推荐胸神经阻滞提供有效的疼痛管理和早期出院时间从PACU乳房切除术后的乳腺癌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of infiltration analgesia and pectoral nerve block in the pain management after mastectomy for breast cancer
INTRODUCTION: In this study, we aimed to compare the superiority of infiltration analgesia and pectoral nerve block methods on pain scores, total opioid consumption and discharge time from post anesthesia care unit (PACU) of patients after oncologic mastectomy. METHODS: After approval of the ethics committee and patient consent, sixty patients who underwent mastectomy for breast cancer between 18-80 years of age were included in the study. Patients were divided into two groups, who underwent pectoral nerve block for postoperative analgesia as Group I and infiltration analgesia as Group II. Intraoperative tenoxicam of 20 mg was applied to all patients. Postoperative pain was evaluated with Visual Analog Scala (VAS) at the 1st, 6th, 12th and 24th hours. Patients with a VAS of more than 3 were given tramadol 1 mg/kg and morphine (05-1 mg) if necessary. In the first 24 hours postoperatively, total analgesic consumption, discharge time from PACU, rates of nausea, vomiting and other side effects of patients were recorded and results were evaluated statistically. RESULTS: Demographic characteristics were similar in two groups. Postoperative VAS scores were significantly lower in the pectoral nerve block group at the 1st, 6th, 12th and 24th hours compared to the infiltration analgesia group. The total analgesic consumption, nauseavomiting rate, and discharge time from PACU were significantly lower in the pectoral nerve block group. DISCUSSION AND CONCLUSION: In our study, pectoral nerve block method was found superior to infiltration analgesia method on postoperative pain management in oncologic breast surgery. In conclusion, we recommend the pectoral nerve block to supply effective pain management and early discharge time from PACU after mastectomy for breast cancer.
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