| Citation: |
WANG Yidan, GUO Qifa, SHEN Tongtao. Clinical effect of erector spinal plane block combined with opiate-free general anesthesia in breast cancer surgery[J]. Journal of Clinical Medicine in Practice, 2023, 27(6): 101-105, 122. DOI: 10.7619/jcmp.20223281
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To observe clinical effect of erector spinae plane block (ESPB) combined with opioid-free general anesthesia in patients undergoing breast cancer surgery.
A total of 60 female patients aged 20 to 65 years and American Society of Association (ASA) type of class Ⅰ to Ⅱ undergoing unilateral breast cancer surgery were selected as study objects, and were randomly divided into group E(ESPB combined with opioid-free general anesthesia) and group C (opioid-free general anesthesia), with 30 cases in each group. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T0), after anesthesia induction (T1), after laryngeal mask implantation (T2), after skin incision (T3), 1 h after operation (T4) and at the end of surgery (T5). Visual analogue scale (VAS) scores at rest and activity and analgesia within 48 h after surgery were recorded at PACU, postoperative 2 h, 6 h, 12 h, 24 h and 48 h. Postoperative extubation time, PACU residence time, first anal exhaust and ambulation time, and the occurrence of adverse reactions within 48 h after surgery were observed and recorded in two groups.
Compared with T0, MAP and HR were all lower at T1 to T4 in group C (P < 0.05). Compared withT0, MAP at T1 to T4 and HR at T1 to T5 in group E were decreased, and the differences were statistically significant (P < 0.05). Compared with group C, group E had a higher MAP at T1 and a lower HR at T4, and the difference was statistically significant (P < 0.05). There were 12 (41.4%) and 4 (14.3%) cases of intraoperative hypotension in group C and group E, respectively. The proportion of hypotension in the group E was lower than that in group C (P < 0.05). Compared group C, the VAS scores entering PACU and within postoperative 2 h were lower, and VAS score at activity entering PACU was lower(P < 0.05). PACU residence time and first anal exhaust time in the group E were shorter than those in group C (P < 0.05). No obvious bradycardia was observed in the two groups within 48 h after operation. The incidence of total adverse reactions in the group E within 48 h after surgery was lower than that in group C, especially the incidence of postoperative nausea and vomiting, the difference was statistically significant (P < 0.05).
ESPB combined with opioid-free general anesthesia has satisfactory clinical efficacy and less complication, which is beneficial for Rapid postoperative recovery.
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