PDF(Pubmed)
Abstract：
Breast cancer is unfortunately the most common cancer in women, although survival rates have greatly increased in recent years. Breast surgery can be very aggressive and therefore highly painful, leading to high rates of acute postsurgical pain and chronic pain. In addition to general anesthesia (GA), ultrasound-guided regional anesthesia (RA) is sometimes performed to help reduce acute postoperative pain and consumption of opioids. Although effective, the main limitation of fascial plane blocks is that they require high volumes of local anesthetics, carrying the risk of local anesthetic systemic toxicity. In this article, we present the case of a 41-year-old woman, who refused GA and was successfully operated on for bilateral breast cancer, under a spontaneous breathing opioid-free sedation and ultrasound-guided RA, based on only 0.2% levobupivacaine with the addition of dexamethasone and dexmedetomidine as adjuvants. Despite this, postoperative analgesia lasted for more than 48 hours, and the patient did not require additional analgesia or opioids.
摘要：
不幸的是，乳腺癌是女性最常见的癌症，尽管近年来生存率大大提高。乳房手术可能非常激进，因此非常痛苦，导致急性术后疼痛和慢性疼痛的发生率很高。除了全身麻醉（GA），超声引导下的区域麻醉(RA)有时有助于减少术后急性疼痛和阿片类药物的消耗.虽然有效,筋膜平面阻滞的主要局限性是它们需要大量的局部麻醉药，携带局麻药全身毒性的风险。在这篇文章中,我们介绍一个41岁女性的案例，拒绝GA并成功进行双侧乳腺癌手术，在自主呼吸无阿片类药物镇静和超声引导下，基于仅0.2％左布比卡因，添加地塞米松和右美托咪定作为佐剂。尽管如此,术后镇痛持续48小时以上,患者不需要额外的镇痛或阿片类药物。
