超声引导下胸神经阻滞复合全身麻醉用于乳腺良性肿瘤切除术麻醉效果及对血流动力学稳定性的影响OA
Anesthetic efficacy of ultrasound-guided pectoral nerves block type Ⅱ combined with general anesthesia in the resection of benign breast tumors and its impact on hemodynamic stability
目的 探讨超声引导下胸神经阻滞(PECS Ⅱ)复合全身麻醉用于乳腺良性肿瘤切除术麻醉效果及对血流动力学稳定性的影响.方法 选择2023年4月-2025年4月拟行乳腺纤维瘤切除术的98例女性患者,按随机数字表法分为胸神经阻滞组(P组)和局部浸润麻醉组(L组),每组49例.P组采用PECS Ⅱ复合全身麻醉方案,L组采用局部浸润麻醉方案.记录手术时间、术中丙泊酚用药总量、术中丙泊酚追加次数、术后镇痛药物首次干预时间和术后24 h内舒芬太尼用量.记录麻醉前、切皮时、术中和术毕各时段的心率、平均动脉压(MAP)及血氧饱和度(SpO2).于术后0.5、2、4和6 h,采用疼痛视觉模拟评分法(VAS)评估患者疼痛程度.结果 两组手术时间比较差异无统计学意义(P＞0.05).P组术中丙泊酚用药总量、术中丙泊酚追加次数及术后24 h内舒芬太尼用量明显少于L组,术后镇痛药物首次干预时间明显长于L组(P＜0.01).切皮时、术中和术毕,P组心率明显低于L组,MAP和SpO2明显高于L组(P＜0.05,P＜0.01).术后0.5、2、4和6h,P组VAS评分均低于L组(P＜0.01).结论 超声引导下的PECS Ⅱ复合全身麻醉对乳腺良性肿瘤切除术患者的麻醉效果好,术中血流动力学稳定,术后疼痛感较轻.
Objective To investigate the anesthetic efficacy of ultrasound-guided pectoral nerves block type Ⅱ(PECS Ⅱ block)combined with general anesthesia in the resection of benign breast tumors and its impact on hemodynamic stability.Methods A total of 98 female patients undergoing elective resection of breast fibroma between April 2023 and April 2025 were enrolled.According to random number table method,they were divided into PECS Ⅱ block group(group P,n=49,PECS Ⅱ block combined with general anesthesia)and local infiltration anesthesia group(group L,n=49,local infiltration anesthesia).The duration of operation,intraoperative total dosage of Propofol,additional times of intraoperative Propofol,the first intervention time of postoperative analgesics and dosage of Sufentanil within 24 h after surgery,heart rate,mean arterial pressure(MAP)and oxyhemoglobin saturation(SpO2)before anesthesia,immediately after skin incision,during surgery and after surgery were recorded.At 0.5 h,2 h,4 h and 6 h after surgery,pain degree of patients was evaluated by visual analogue scale(VAS).Results The difference in the duration of operation between the two groups was not statistically significant(P＞0.05).The intraoperative total dosage of Propofol,additional times of intraoperative Propofol and dosage of Sufentanil within 24h after surgery in group P were significantly lower than those in group L,and the first intervention time of postoperative analgesics was significantly longer than that in group L(P＜0.01).Immediately after skin incision,during surgery and after surgery,heart rate in group P was significantly lower than that in group L,while MAP and SpO2 were significantly higher than those in group L(P＜0.05,P＜0.01).At 0.5 h,2 h,4 h and 6 h after surgery,VAS scores in group P were lower than those in group L(P＜0.01)Conclusion Ultrasound-guided PECS Ⅱ block combined with general anesthesia provides satisfactory anesthetic efficacy in patients undergoing resection of benign breast tumors,which has stable intraoperative hemodynamics and mild postoperative pain.
刘素环;刘印华;全燕;胡剑梅;李刚
秦皇岛市妇幼保健院麻醉科,河北秦皇岛 066000秦皇岛市妇幼保健院麻醉科,河北秦皇岛 066000秦皇岛市妇幼保健院麻醉科,河北秦皇岛 066000秦皇岛市妇幼保健院麻醉科,河北秦皇岛 066000秦皇岛市中医医院麻醉科,河北秦皇岛 066000
乳腺良性肿瘤切除术全身麻醉超声引导下胸神经阻滞平均动脉压血氧饱和度镇痛
resection of benign breast tumorgeneral anesthesiaultrasound-guided pectoral nerves block type Ⅱmean arterial pressureoxyhemoglobin saturationanalgesia
《临床误诊误治》 2026 (10)
33-38,6
河北省医学科学研究重点课题计划项目(20241629)秦皇岛市妇幼保健院科技支撑计划项目(202301A274)
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