PDF(Pubmed)
Abstract：
BACKGROUND: Inadequate acute postoperative pain control after modified radical mastectomy (MRM) can compromise pulmonary function. This work aimed to assess the postoperative pulmonary effects of a single-shot thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) in female patients undergoing MRM.
METHODS: This prospective, randomized comparative trial was conducted on 40 female American Society of Anesthesiologists (ASA) II-III, aged 18 to 50 years undergoing MRM under general anesthesia (GA). Patients were divided into two equal groups (20 in each group): Group I received ESPB and Group II received TPVB. Each group received a single shot with 20 ml volume of 0.5% bupivacaine.
RESULTS: Respiratory function tests showed a comparable decrease in forced vital capacity (FVC) and forced expiratory volume (FEV1) from the baseline in the two groups. Group I had a lower FEV1/FVC ratio than Group II after 6 h. Both groups were comparable regarding duration for the first postoperative analgesic request (P value = 0.088), comparable postoperative analgesic consumption (P value = 0.855), and stable hemodynamics with no reported side effects.
CONCLUSIONS: Both ultrasound guided ESPB and TPVB appeared to be effective in preserving pulmonary function during the first 24 h after MRM. This is thought to be due to their pain-relieving effects, as evidenced by decreased postoperative analgesic consumption and prolonged time to postoperative analgesic request in both groups.
RESULTS:
UNASSIGNED: NCT03614091 registration date on 13/7/2018.
METHODS: This prospective, randomized comparative trial was conducted on 40 female American Society of Anesthesiologists (ASA) II-III, aged 18 to 50 years undergoing MRM under general anesthesia (GA). Patients were divided into two equal groups (20 in each group): Group I received ESPB and Group II received TPVB. Each group received a single shot with 20 ml volume of 0.5% bupivacaine.
RESULTS: Respiratory function tests showed a comparable decrease in forced vital capacity (FVC) and forced expiratory volume (FEV1) from the baseline in the two groups. Group I had a lower FEV1/FVC ratio than Group II after 6 h. Both groups were comparable regarding duration for the first postoperative analgesic request (P value = 0.088), comparable postoperative analgesic consumption (P value = 0.855), and stable hemodynamics with no reported side effects.
CONCLUSIONS: Both ultrasound guided ESPB and TPVB appeared to be effective in preserving pulmonary function during the first 24 h after MRM. This is thought to be due to their pain-relieving effects, as evidenced by decreased postoperative analgesic consumption and prolonged time to postoperative analgesic request in both groups.
RESULTS:
UNASSIGNED: NCT03614091 registration date on 13/7/2018.
摘要：
背景：改良根治术（MRM）后急性术后疼痛控制不足会损害肺功能。这项工作旨在评估单次胸椎旁阻滞（TPVB）和竖脊肌平面阻滞（ESPB）对接受MRM的女性患者的术后肺部影响。
方法：这种前瞻性，对40名女性美国麻醉医师协会（ASA）II-III进行了随机比较试验，18至50岁，在全身麻醉（GA）下接受MRM。患者分为两组（每组20例）：第一组接受ESPB，第二组接受TPVB。每组接受20ml体积的0.5％布比卡因单次注射。
结果：呼吸功能测试显示，两组的用力肺活量（FVC）和用力呼气量（FEV1）均较基线降低。6小时后，I组的FEV1/FVC比低于II组。两组在第一次术后镇痛请求的持续时间方面具有可比性（P值=0.088），术后镇痛消耗量相当（P值=0.855），血流动力学稳定，无副作用。
结论：超声引导下的ESPB和TPVB在MRM后的最初24小时内似乎都能有效保护肺功能。这被认为是由于它们的疼痛缓解作用，两组患者术后镇痛消耗量减少，术后镇痛需求时间延长。
结果：
■NCT03614091注册日期为2018年7月13日。
方法：这种前瞻性，对40名女性美国麻醉医师协会（ASA）II-III进行了随机比较试验，18至50岁，在全身麻醉（GA）下接受MRM。患者分为两组（每组20例）：第一组接受ESPB，第二组接受TPVB。每组接受20ml体积的0.5％布比卡因单次注射。
结果：呼吸功能测试显示，两组的用力肺活量（FVC）和用力呼气量（FEV1）均较基线降低。6小时后，I组的FEV1/FVC比低于II组。两组在第一次术后镇痛请求的持续时间方面具有可比性（P值=0.088），术后镇痛消耗量相当（P值=0.855），血流动力学稳定，无副作用。
结论：超声引导下的ESPB和TPVB在MRM后的最初24小时内似乎都能有效保护肺功能。这被认为是由于它们的疼痛缓解作用，两组患者术后镇痛消耗量减少，术后镇痛需求时间延长。
结果：
■NCT03614091注册日期为2018年7月13日。
