Study on clinical effect of ultrasound-guided transverse thoracic muscle plane block with different concentrations of ropivacaine in radical mastectomy
Objective To analyze the clinical effect of ultrasound-guided transverse thoracic muscle plane block with different concentrations of ropivacaine in radical mastectomy.Methods 120 patients undergoing radical mastectomy were randomly divided into group A,group B and group C,with 40 cases in each group.All the three groups received ultrasound-guided transversal thoracic muscle plane block.Group A was given 0.25% ropivacaine,group B was given 0.3% ropivacaine,and group C was given 0.375% ropivacaine.The analgesia related indicators,pain score,Ramsay sedation score and incidence of adverse reactions were compared among the three groups.Results Group C had remifentanil dosage of(1.07±0.22)mg during surgery and dosage of analgesic drugs of(93.26±1.36)ml at 48 h after surgery,which were less than those in group B[(1.32±0.25)mg and(96.84±1.76)ml]and group A[(1.58±0.38)mg and(99.42±1.77)ml];all patients in group B were less than patients in group A;the difference was statistically significant(P<0.05).At 3 and 6 h after surgery,the VAS scores of group A were(4.24±0.51)and(3.35±0.44)points,those of group B were(3.89±0.45)and(2.98±0.42)points,and those of group C were(3.25±0.54)and(2.12±0.35)points.At 3 and 6 h after surgery,VAS scores of the three groups were significantly different(P<0.05).The VAS score of group C was lower than that of group A and group B,and group B was lower than group A.The difference was statistically significant(P<0.05).There was no significant difference in Ramsay sedation score at 1 h after surgery among the three groups(P>0.05).The incidence of adverse reactions was 5.00% in group A,5.00% in group B and 7.50% in group C,and there was no statistical significance among the three groups(P>0.05).Conclusion Ultrasound-guided transverse thoracic muscle plane block with more than 0.3% ropivacaine concentration is safe and effective in radical mastectomy,and can reduce intraoperative anesthesia and postoperative analgesia,,and the postoperative analgesia effect is satisfactory without increasing adverse reactions.
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