Efficacy of Pectoral Nerve Block Type II for Breast-Conserving Surgery and Sentinel Lymph Node Biopsy: A Prospective Randomized Controlled Study.
Efficacy of Pectoral Nerve Block Type II for Breast-Conserving Surgery and Sentinel Lymph Node Biopsy: A Prospective Randomized Controlled Study.
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DOI：
10.1155/2018/4315931
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发表时间：
2018
影响因子：
2.9
通讯作者：
Choi KT
中科院分区：
文献类型：
--
作者：
Kim DH;Kim S;Kim CS;Lee S;Lee IG;Kim HJ;Lee JH;Jeong SM;Choi KT
胸神经阻滞II型（PECS II型）被广泛应用于乳房手术后镇痛。本研究评估了PECS II阻滞在保乳手术（BCS）和前哨淋巴结活检（SNB）患者中的镇痛效果。患者随机分为对照组（n=40）和PECS II组（n=40）。诱导麻醉后行超声引导的PECS II阻滞。主要指标是阿片类药物的消耗，次要指标是术后24小时用数值评定量表（NRS）测量的乳房和腋窝疼痛。根据肿瘤位置评估阿片类药物需求。PECS II组阿片类药物需求低于对照组（43.8±28.5µg vs 77.0±41.9µg, p < 0.001）。然而，两组间使用镇痛药的频率并无差异。在PECS II组中，外区肿瘤患者的阿片类药物消耗量明显低于内区肿瘤患者（32.5±23.0µg vs 58.0±29.3µg, p=0.007）。在PECS II组，腋窝NRS在24小时内持续降低。尽管PECS II阻滞似乎减轻了BCS和SNB后24小时的疼痛强度和阿片类药物需求，但这些减少可能没有临床意义。该试验已注册临床研究信息服务中心KCT0002509。
The pectoral nerve block type II (PECS II block) is widely used for postoperative analgesia after breast surgery. This study evaluated the analgesic efficacy of PECS II block in patients undergoing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SNB). Patients were randomized to the control group (n=40) and the PECS II group (n=40). An ultrasound-guided PECS II block was performed after induction of anesthesia. The primary outcome measure was opioid consumption, and the secondary outcome was pain at the breast and axillary measured using the Numerical Rating Scale (NRS) 24 hours after surgery. Opioid requirement was assessed according to tumor location. Opioid requirement was lower in the PECS II than in the control group (43.8 ± 28.5 µg versus 77.0 ± 41.9 µg, p < 0.001). However, the frequency of rescue analgesics did not differ between these groups. Opioid consumption in the PECS II group was significantly lower in patients with tumors in the outer area than that in patients with tumors in the inner area (32.5 ± 23.0 µg versus 58.0 ± 29.3 µg, p=0.007). The axillary NRS was consistently lower through 24 hr in the PECS II group. Although the PECS II block seemed to reduce pain intensity and opioid requirements for 24 h after BCS and SNB, these reductions may not be clinically significant. This trial is registered with Clinical Research Information Service KCT0002509.
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