Comparison of analgesic effect of ultrasound-guided pectoralis nerves block and erector spinal plane block in modified radical resection for breast cancer
ZHU Yunqing1 WEI Guohua2 YU Min2 ZHOU Xiaokai2
1.The First Clinical Medical College, Nanjing Medical University, Jiangsu Province, Nanjing 210006, China; 2.Department of Anesthesiology, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Province, Nanjing 210029, China
Abstract：Objective To compare the analgesic effect of ultrasound-guided pectoralis nerves block (PECS) and erector spinae plane block (ESPB) in modified radical mastectomy for breast cancer. Methods A total of 80 female patients diagnosed with stage Ⅰ-Ⅱ primary breast cancer by menstrual puncture biopsy and selected for modified radical mastectomy in First Affiliated Hospital with Nanjing Medical University from January to October 2022 were selected. They were divided into PECS group (group A) and ESPB group (group B) by random number table method, with 40 cases in each group. After anesthesia induction, group A was given PECS under ultrasound-guidance, including 0.25% Ropivacaine injected into 10 ml by type Ⅰ PECS intraplane technique and 0.25% Ropivacaine injected into 15 ml by type Ⅱ PECS intraplane technique; in group B, 0.25% Ropivacaine 25 ml was injected into the transverse surface of T4 using ultrasound-guided ESPB. The numerical rating scale (NRS) scores at 15 min, 30 min, 60 min, 120 min, 12 h, and 24 h after surgery were compared between two groups; intraoperative amount of Fentanyl, postoperative dose of Tramadol, and number of cases requiring remedial analgesia after surgery were compared between two groups; the occurrence of adverse reactions in the two groups was observed. Results There were statistically significant differences in the inter-group, time, and interaction effects of NRS scores between two groups (P＜0.05). In group A, the NRS scores at 60 min and 120 min after surgery were higher than those at 15 min and 30 min after surgery; NRS score at 120 min after surgery was higher than that at 60 min after surgery; NRS score at 24 h after surgery was lower than that at 60 min, 120 min, and 12 h after surgery, and the differences were statistically significant (P＜ 0.05). In group B, The NRS scores at 60 min, 120 min, 12 h, and 24 h after surgery were higher than those at 15 min and 30 min after surgery; NRS score at 12 h after surgery was higher than that at 60 min after surgery; NRS score at 24 h after surgery was lower than that at 120 min and 12 h after surgery, and the differences were statistically significant (P＜0.05). The NRS scores at 60 min, 120 min, 12 h, and 24 h after surgery in group A were lower than those in group B, and the differences were statistically significant (P＜0.05); there were no significant differences in NRS scores at 15 and 30 min after surgery between two groups (P＞0.05). There was no significant difference in intraoperative amount of Fentanyl between two groups (P＞0.05); the postoperative dose of Tramadol, number of cases requiring remedial analgesia after surgery in group A were lower than those in group B, and the differences were statistically significant (P＜0.05). There was no significant difference in the total incidence of adverse reactions between two groups (P＞0.05). Conclusion Ultrasound-guided PECS in modified radical mastectomy for breast cancer can provide better postoperative analgesia and reduce the postoperative dose of analgesic drugs.
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2023, Vol. 20 
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