蚌埠医学院学报2024,Vol.49Issue(11) :1434-1437.DOI:10.13898/j.cnki.issn.1000-2200.2024.11.005

艾司氯胺酮联合前锯肌平面阻滞在乳腺癌改良根治术中的应用

Aapplication value of esketamine combined with serratus anterior plane block in modified radical mastectomy of breast cancer

刘梦雅 刘元 杨振 徐直 王南海
蚌埠医学院学报2024,Vol.49Issue(11) :1434-1437.DOI:10.13898/j.cnki.issn.1000-2200.2024.11.005

艾司氯胺酮联合前锯肌平面阻滞在乳腺癌改良根治术中的应用

Aapplication value of esketamine combined with serratus anterior plane block in modified radical mastectomy of breast cancer

刘梦雅 1刘元 2杨振 1徐直 1王南海1
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作者信息

  • 1. 蚌埠医科大学第一附属医院麻醉科,安徽蚌埠 233004
  • 2. 蚌埠医科大学第一附属医院肿瘤外科,安徽蚌埠 233004
  • 折叠

摘要

目的:探究艾司氯胺酮联合超声引导下前锯肌平面阻滞(SAPB)在乳腺癌改良根治术中的应用价值.方法:选取60例拟行喉罩全麻下的单侧乳腺癌改良根治术病人,年龄20~60岁,体质量指数(BMI)18~24.5 kg/m2,进行随机分组.对照组(C组)行超声引导下前锯肌平面阻滞,局麻药为0.25%罗哌卡因;观察组(S组)在对照组基础之上,手术结束前30 min静脉给予艾司氯胺酮0.25 mg/kg.术后镇痛均采用静脉自控镇痛(PCIA).观察2组围术期观察指标、术后镇静、镇痛评分及不良反应与行SPAB的并发症发生率.结果:S组的首次按压镇痛泵时间长于C组,术后48 h镇痛泵按压次数及术后24 h和48 h舒芬太尼用量少于C组,术后3 h、6 h、12 h的镇痛程度高于C组,且不良反应总发生率低于C组,差异均有统计学意义(P<0.05).2组间术后3 h、6 h、12 h、24 h、48 h的镇静评分、术后24 h与48 h的疼痛评分对比差异均无统计学意义(P>0.05).结论:艾司氯胺酮联合超声引导下SAPB在乳腺癌改良根治术中镇痛效果理想且不良反应少.

Abstract

Objective:To explore the application value of esketamine combined with ultrasound-guided serratus anterior plane block(SAPB)in modified radical mastectomy of breast cancer.Methods:A total of 60 patients aged 20-60 years and BMI 18~24.5 kg/m2 scheduled by modified radical mastectomy under laryngeal mask general anesthesia were selected,and randomly divided into the observation group(group S)and control group(group C).The group C received the anterior serrated muscle plane block under ultrasound guidance and 0.25%ropivacaine as local anesthetics.On the basis of the control group C,the group S was given intravenous esketamine 0.25 mg/kg 30 min before the end of the operation.The postoperative controlled intravenous analgesia(PCIA)was given in two groups.The perioperative observation indexes,postoperative sedation,analgesia scores,adverse reactions and complication rate of SPAB were observed in two groups.Results:The time of first analgesic pump compression in the group S was longer than that in group C,the number of analgesic pump compression after 48 h of surgery and dosage of sufentanil after 24 h and 48 h of surgery in the group S were lower than those in group C,the degree of analgesia after 3 h,6 h and 12 h of surgery in the group S were higher than that in group C,and the total incidence rate of adverse reactions in the group S was lower than that in group C(P<0.05).There was no statistical significance in the sedation scores after 3 h,6 h,12 h,24 h and 48 h and pain scores after 24 h and 48 h of operation between two groups(P>0.05).Conclusions:Esketamine combined with ultrasound-guided SAPB has ideal analgesic effects and less adverse reactions in modified radical mastectomy.

关键词

乳腺肿瘤/艾司氯胺酮/前锯肌平面阻滞

Key words

breast neoplasms/esketamine/serratus anterior plane block

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出版年

2024
蚌埠医学院学报
蚌埠医学院

蚌埠医学院学报

CSTPCD
影响因子:0.917
ISSN:1000-2200
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