胸部神经块用于乳腺癌手术:系统性审查和元分析
Hewan Alemayehu1, Rebecca Litchholt2, Kathryn Metcalf3
1CRNA at Heda Anesthesia Solutions, Washington, DC.
AANA journal
|February 3, 2026
概括
胸部神经阻塞 (PECS) 在乳腺癌患者中显著减少术后疼痛和阿片类药物使用. 这些阻塞通过增强疼痛控制和减少恶心和吐来改善恢复.
科学领域:
- 麻醉学 麻醉学
- 在瘤学瘤学.
- 疼痛管理 疼痛管理
背景情况:
- 乳腺癌手术经常导致显著的术后疼痛.
- 阿片类药物通常用于治疗疼痛,但有副作用.
- 胸部神经阻塞 (PECS I和II) 为疼痛控制提供了一个潜在的替代方案.
研究的目的:
- 在乳腺癌手术中系统地审查和元分析PECS阻断的疗效,与安慰剂相比.
- 评估PECS阻断对术后疼痛,阿片类药物消耗和恢复的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了多个数据库,包括Cochrane协作,PubMed,CINAHL,谷歌学者和灰色文学.
- 包括22个RCT,将PECS I或II块与安慰剂进行比较,分析疼痛得分,阿片类药物使用,止痛时间以及术后恶心和吐 (PONV).
主要成果:
- PECS 阻断显著降低了在休息和活动期间的疼痛评分,直至手术后48小时.
- 在手术期间和手术后,阿片类药物的使用明显减少.
- 延长了第一次救援止痛的时间,并减少了PONV的发生率. 没有观察到对慢性疼痛的显著影响.
结论:
- PECS 阻塞在改善乳腺癌手术后的术后疼痛控制方面是有效的.
- 它们通过减少阿片类药物需求和促进患者康复,在多模式止痛中发挥着宝贵的作用.
- 进一步的研究可能会探索长期影响和最佳技术.
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