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在乳房切除手术中不使用阿片类药物的区域麻醉,然后用植入物进行乳房重建:一项随机对照研究

Domagoj Eljuga, Rhea Marie Mužar¹, Ivo Jurišić

¹Rhea Marie Mužar, Department of Plastic and Reconstructive Surgery, Dubrava University Hospital, Av. Gojka Šuška 6, 10000 Zagreb, Croatia, rmuzar@kbd.hr.

Croatian medical journal

|July 10, 2025

概括

区域麻醉与三个块的组合提供了乳房重建后的长期缓解疼痛,消除了阿片类药物的使用. 进一步的研究可能会将其作为乳腺手术疼痛管理的新标准.

科学领域:

麻醉学麻醉学
手术瘤学手术瘤学
整形外科整形外科整形外科

背景情况:

优化疼痛管理和乳房切除和乳房重建后的恢复至关重要.
区域麻醉技术被探索为一般麻醉的替代方案,以减少阿片类药物依赖.

研究的目的:

为了比较多模区域麻醉技术与全身麻醉在疼痛控制,阿片类药物消耗和住院时间方面的疗效.
评估区域麻醉在接受前胸部乳房重建的患者提供长期缓解疼痛的效果.

主要方法:

一项随机对照试验,涉及40名接受乳房切除术的患者,并进行前胸部乳房重建.
区域麻醉组接受了胸部肌肉阻断 (PECS I),胸部副脊椎阻断 (TPVB) 和前肌肉平面阻断 (SAP).
对照组接受了全身麻醉. 使用数值评分尺度 (NRS) 评估疼痛,直至术后10天.

主要成果:

与全身麻醉相比,区域麻醉在术后10天内显著提高了NRS疼痛评分.
两组之间在阿片类药物消费或住院时间方面没有发现显著差异.
区域麻醉组的疼痛评分无论患者的日常体力活动水平如何,都会升高.

结论:

综合区域麻醉方法 (TPVB,PECS I,SAP) 在乳腺手术后提供持续的无阿片类药物止痛.
该区域麻醉方案显示了为乳房重建患者在术后疼痛管理中建立新的黄金标准的潜力.
需要进一步的研究来完善和验证这种多模式区域麻醉技术,以便在临床上广泛采用.

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