胸部神经和副脊椎阻塞在乳腺外科手术后疼痛管理的比较:多中心随机双盲试验
Roberto Dossi1, Edoardo Tasciotti1, Kuijk van Sander2,3
1Service of Anaesthesiology, Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland.
Journal of breast cancer
|September 1, 2025
概括
胸部神经 (PECS) 阻断与副脊椎阻断 (PVB) 在乳腺癌手术疼痛中同样有效,应用速度更快,安全性较好. 这支持PECS阻断在乳腺癌疼痛管理中的使用.
科学领域:
- 麻醉学
- 治疗疼痛
- 癌症学
背景情况:
- 胸部神经阻塞 (PECS) 越来越多地用于乳腺癌手术缓解疼痛,因为它们的安全性和易用性.
- 在术后止痛方面,PECS阻断与副脊椎阻断 (PVB) 的比较有效性仍在研究中.
- 临床试验.gov 标识:NCT02645474.
研究的目的:
- 在乳腺癌手术患者的术后止痛中,评估PECS阻断与PVB相比的非劣势.
- 评估PECS阻断剂在手术后降低疼痛评分和阿片类药物的有效性.
主要方法:
- 一个前性,随机,双盲试验,涉及接受选择性乳腺癌手术的成年患者.
- 患者被随机分为接受PECS阻断或PVB.
- 主要结局是手术后30分钟,6小时和24小时的阻断成功 (视觉模拟量级疼痛分数< 30). 二级结局包括阿片类药物消耗,阻断时间,功能恢复和患者满意度.
主要成果:
- 在30分钟后,PECS与PVB的区块成功率为69.6%与63. 2%,在6小时后为81. 8%与68. 4%,在24小时后为77. 3%与88. 9%.
- 在手术后的30分钟和6小时内,PECS阻断被发现与PVB无差别,但在24小时后没有确定性.
- PECS阻断显示显著更快的性能 (7对14分钟,p < 0. 001) 与可比的阿片类药物消耗,患者满意度和功能恢复,没有报告的并发症.
结论:
- 胸部神经 (PECS) 阻塞在乳腺癌手术中的术后疼痛管理中不低于副脊椎阻塞 (PVB).
- PECS 块具有优势,包括减少施用时间和有利的安全性.
- 这些发现支持将PECS阻断纳入乳腺癌患者的多模式疼痛管理策略.
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