Abstract：
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction. Fifteen out of 16 cases were successfully completed under sedation and regional anaesthesia, with one conversion to general anaesthesia. Eleven out of 16 cases required low-dose intra-operative opioid analgesia. Out of the 15 surgical procedures completed under regional anaesthesia with sedation, all patients experienced either no or minimal intra-operative pain, and all would choose this anaesthetic technique again. Surgeon-reported operating conditions were \'indistinguishable from general anaesthesia\' in most cases, and surgeons were \'extremely satisfied\' or \'satisfied\' with the technique after every procedure. Combined thoracic paravertebral plus pectoral nerve block with intra-operative sedation is a feasible technique for breast surgery.
摘要：
乳房手术避免全身麻醉可能是由于临床原因或患者选择。有新的证据表明，使用区域麻醉和避免使用挥发性麻醉剂和阿片类药物镇痛可能对肿瘤学结果有益。我们进行了一项前瞻性观察病例系列，包括16例乳腺癌手术，在胸椎旁联合胸神经阻滞和丙泊酚镇静下进行，以证明技术的可行性。患者可接受性和外科医生满意度。16例中15例在镇静和区域麻醉下顺利完成,一次转换为全身麻醉。16例中有11例需要低剂量的术中阿片类药物镇痛。在区域麻醉和镇静下完成的15项外科手术中，所有患者都没有经历或经历了轻微的术中疼痛，所有人都会再次选择这种麻醉技术。在大多数情况下，外科医生报告的手术条件与全身麻醉无法区分，外科医生在每次手术后都对该技术“非常满意”或“满意”。胸椎旁联合胸神经阻滞术中镇静是一种可行的乳腺手术技术。
