医学
Pacu公司
麻醉
安慰剂
芬太尼
类阿片
舒芬太尼
随机对照试验
外科
神经阻滞
乳房切除术
乳房外科
乳腺癌
内科学
癌症
病理
受体
替代医学
作者
Barbara Versyck,Geert‐Jan van Geffen,Patrick Van Houwe
标识
DOI:10.1016/j.jclinane.2017.03.054
摘要
The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. A prospective randomized double blind placebo-controlled study. A secondary hospital. 140 breast cancer stage 1–3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection. Patients were randomized to receive either a Pecs block with levobupivacaine 0.25% (n = 70) or placebo block with saline (n = 70). The pain levels were evaluated by Numeric Rating Scale (NRS) pain scores at 15-minute intervals during the post anesthesia care unit stay time (PACU), at 2-hour intervals for the first 24 h on the ward and at 4-hour intervals for the next 24 h. Intraoperative and postoperative opioid consumption were recorded during the full stay. Patient satisfaction was evaluated upon discharge using a 10-point scale. Intraoperative sufentanil requirements were comparable for the Pecs and placebo group (8.0 ± 3.5 μg and 7.8 ± 3.0 μg, P = 0.730). Patients in the Pecs group experienced significantly less pain than patients in the control group (P = 0.048) during their PACU stay. Furthermore, patients in the Pecs group required significant less postoperative opioids (9.16 ± 10.15 mg and 14.97 ± 14.38 mg morphine equivalent, P = 0.037) and required significant fewer postsurgical opioid administration interventions than patients in the control group (P = 0.045). Both patient-groups were very satisfied about their management (9.6 ± 0.6 and 9.1 ± 1.8 on a 10-point scale, P = 0.211). The Pecs block reduces postsurgical opioid consumption during the PACU stay time for patients undergoing breast surgery.
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