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《Journal of Medical Research》 2020-04
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Efficacy of Ultrasound-guided Pectoral Nerve Block Versus Erector Spinae Plane Block for Postoperative Analgesia after Modified Radical Mastectomy

Chen Chengzhe;Li Huifang;Ren Yifeng;Department of Anesthesia, First Affiliated Hospital of Henan University;  
Objective To compare the analgesic effect of ultrasound-guided pectoral nerves Ⅱ(PECS Ⅱ) block and erector spine plane(ESP) block after modified radical mastectomy. Methods Ninety-eight female patients who underwent modified radical mastectomy for unilateral breast cancer between June 2018 and June 2019 were randomly divided into ultrasound-guided Pecs Ⅱ group(Group P), ultrasound-guided ESP group(Group E) and control group(Group C), with 30 cases per group. Numerical rating scales(NRS), intraoperative sufentanil need, postoperative rescue analgesic requirements, morphine consumption, adverse reactions and complication were recorded. Results The general situation of the three groups of patients was compared, and the difference was not statistically significant(P0.05). The intraoperative sufentanil need in group C(33.4±3.4μg) was significantly higher than that in group P(26.1±3.1μg) and group E(27.6±3.1μg), and the difference was statistically significant(t=-8.742, P=0.000;t=-6.957, P=0.000). Group P was lower than group E, and the difference was not statistically significant(t=-1.888, P=0.064). The postoperative rescue analgesic requirements at 24 h was significantly lower in group P(3 cases) than group E(10 cases) and group C(13 cases). The difference was statistically significant(χ~2=4.812, P=0.028;χ~2=8.523, P=0.004). The group E was less than the group C, and the difference was not statistically significant(χ~2=0.635, P=0.426). Morphine consumption at 24 h after surgery in group P(0.7±1.7 mg) was significantly lower than group C(2.3±2.9 mg), and the difference was statistically significant(t=-2.734, P=0.008). Group P was lower than group E(1.8±2.8 mg), group E was lower than group C, and the difference was not statistically significant(t=-1.952, P=0.056; t=-0.687, P=0.495). The NRS scores at 3, 6, 12, 24 h after surgery in group P were 0.7±0.7, 1.4±0.7, 1.6±0.6, 1.7±0.6,in the group E were 1.2±0.7, 2.1±0.7, 2.2 ±0.9, 1.7±0.5, and in group C were 1.4±0.8, 2.4±0.6, 2.4±0.9, 1.8±0.4. The NRS scores at 3, 6, and 12 h after surgery were significantly lower in the group P than the groups E and C, and the difference was statistically significant(t=-2.833, P=0.006; t=-3.851, P=0.000; t=-2.876, P=0.006; t=-3.409, P=0.001; t=-5.581; P=0.000; t=-4.619, P=0.000). Group E was lower than group C, and the difference was not statistically significant(t=-0.872, P=0.387; t=-1.617, P=0.111; t=-0.846, P=0.401). There was no significant difference in the 24 h NRS scores between the three groups(t=0.000, P=1.000; t=-1.276, P=0.207; t=-1.372, P=0.175).There was no significant difference in adverse reactions at 24 hours after surgery(P0.05). No complication was in the three groups. ConclusionUltrasound-guided Pecs Ⅱ block has better analgesic effect after modified radical mastectomy than ESP block.
【Fund】: 河南省科技发展计划项目(192102310367);; 河南省开封市科技发展计划项目(1803012)
【CateGory Index】: R737.9;R614
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