改良胸廓和星状神经节联合阻滞对改良根治性乳房切除术患者应激和炎症反应的影响

IF 1.6 Q4 ONCOLOGY International Journal of Breast Cancer Pub Date : 2022-06-06 eCollection Date: 2022-01-01 DOI:10.1155/2022/3359130
Jun Geng, Jing Wang, Yaowen Zhang, Wenxiang Song, Junjia Zhu, Jianqing Chen, Zhen Wu
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引用次数: 0

摘要

背景和目的:据报道,区域麻醉可减轻与手术切除相关的应激和炎症反应;然而,对联合神经阻滞的效果却较少进行研究。我们评估了胸神经阻滞(PNB)和星状神经节阻滞(SGB)联合使用是否比单独使用胸神经阻滞更能有效减轻接受改良根治性乳房切除术(MRM)的妇女的这些反应:这是一项前瞻性随机对照试验。方法:这是一项前瞻性随机对照试验,50 名乳腺癌患者被随机分配接受超声引导下的 PNB(n = 25,仅 PNB 组)或超声引导下的 PNB 联合 SGB(n = 25,联合阻断组)。主要结果是围手术期血浆白细胞介素(IL-)6水平。次要结果包括围手术期皮质醇、葡萄糖、IL-8 和肿瘤坏死因子 (TNF-) α 的血浆水平、疼痛评分、血流动力学变量、睡眠质量和术后并发症:结果:联合阻断组术后 24 小时的 IL-6 和 TNF-α 水平明显降低。手术结束时,联合阻断组的皮质醇水平明显降低。联合阻断组在切口时的葡萄糖水平较低。联合阻断组术后 12 小时内的疼痛评分明显降低,围手术期血流动力学稳定性也更好。联合阻滞组患者在手术当晚的睡眠质量更好:结论:在接受 MRM 的患者中,PNB 联合 SGB 阻滞比单用 PNB 更能有效减轻围术期炎症反应。结论:在接受 MRM 的患者中,PNB 联合 SGB 阻滞比单用 PNB 能有效减轻围术期炎症反应,联合阻滞方法还能减轻应激反应和术后急性疼痛,并能稳定围术期血流动力学和提高术后睡眠质量。
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The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical Mastectomy.

Background and aims: Regional anaesthesia reports to attenuate stress and inflammatory responses associated with surgical resection; however, the effectiveness of combined nerve blocks is less often investigated. We evaluated whether a combination of a pectoral nerve block (PNB) and stellate ganglion block (SGB) is more effective than a PNB alone in reducing these responses in women undergoing modified radical mastectomy (MRM).

Methods: This is a prospective randomized controlled trial. Fifty patients with breast cancer were randomly allocated to receive an ultrasound-guided PNB (n = 25, PNB only group) or ultrasound-guided PNB combined with SGB (n = 25, combined blockade group). The primary outcome was perioperative plasma level of interleukin- (IL-) 6. Secondary outcomes included perioperative plasma levels of cortisol, glucose, IL-8, and tumour necrosis factor- (TNF-) α, pain scores, haemodynamic variables, sleep quality, and complications postsurgery.

Results: The combined blockade group exhibited significantly lower IL-6 and TNF-α levels 24 h postsurgery. Cortisol levels were significantly lower in the combined blockade group at the end of the surgery. Glucose levels at the time of incision were lower in the combined blockade group. Pain scores up to 12 h postsurgery were significantly lower in the combined blockade group, which also exhibited better perioperative haemodynamic stability. Patients in the combined blockade group reported better sleep quality on the night of surgery.

Conclusion: In patients undergoing MRM, PNB combined with SGB block effectively blunted perioperative inflammatory response than PNB alone. A combined block approach can also alleviate stress response and postoperative acute pain with stable perioperative haemodynamics and better postoperative sleep quality.

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来源期刊
CiteScore
3.40
自引率
0.00%
发文量
25
审稿时长
19 weeks
期刊介绍: International Journal of Breast Cancer is a peer-reviewed, Open Access journal that provides a forum for scientists, clinicians, and health care professionals working in breast cancer research and management. The journal publishes original research articles, review articles, and clinical studies related to molecular pathology, genomics, genetic predisposition, screening and diagnosis, disease markers, drug sensitivity and resistance, as well as novel therapies, with a specific focus on molecular targeted agents and immune therapies.
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