前锯肌阻滞在乳腺癌改良根治术镇痛方面的荟萃分析
| 作者: |
1方雨心,
1丁建明,
1刘学胜
1 安徽医科大学第一附属医院麻醉科，合肥 230000 |
| 通讯: |
刘学胜
Email: liuxuesheng@ahmu.edu.cn |
| DOI: | 10.3978/j.issn.2095-6959.2021.08.030 |
| 基金: | 国家自然科学基金(81870841)。 |
摘要
目的：系统评价前锯肌平面阻滞(serratus anterior plane block，SAPB)在乳腺癌改良根治术(modified radical mastectomy，MRM)患者中的镇痛效果。方法：检索PubMed、Embase、The Cochrane Library、万方、维普和CNKI数据库，采用RevMan5.4软件进行荟萃分析。结果：共纳入7项研究，荟萃分析结果显示SAPB组在术后静息时1、2、4、6、8、12、24 h，视觉模拟评分(visual analogue scale，VAS)较对照组低(P<0.05)。运动时SAPB组术后1、4、8、12和24 h的VAS评分显著低于对照组(P<0.05)。SAPB组术后24 h内按压患者自控镇痛泵(patient-controlled analgesia，PCA)次数及阿片类药物用量均显著低于对照组(P<0.05)。SAPB组在减少阿片类药物相关不良反应方面也具有优势(P<0.05)，但在缩短手术时间方面2组差异无统计学意义(P>0.05)。结论：SAPB可以提供较好的MRM术后镇痛效果，并且在减少阿片类药物不良反应方面具有显著优势。然而，对手术时间没有明显的影响。
关键词：
前锯肌平面阻滞；乳腺癌改良根治术；镇痛；荟萃分析
A meta-analysis of serratus anterior plane block for analgesia after modified radical mastectomy
CorrespondingAuthor: LIU Xuesheng Email: liuxuesheng@ahmu.edu.cn
DOI: 10.3978/j.issn.2095-6959.2021.08.030
Foundation: This work was supported by the National Natural Sciences Foundation of China (81870841).
Abstract
Objective: To systematically review the analgesic effect of serratus anterior plane block (SAPB) in patients undergoing modified radical mastectomy (MRM). Methods: PubMed, Embase, The Cochrane Library, Wanfang Data, VIP and CNKI were searched and this meta-analysis was performed by RevMan5.4 software. Results: A total of 7 RCTs were included in meta-analysis. The results showed that the visual analoguescale (VAS) score in the SAPB group was lower than that in the control group at 1, 2, 4, 6, 8, 12, 24 h after resting (P<0.05). During exercise, the VAS scores of SAPB group at 1, 4, 8, 12 and 24 h after operation were significantly lower than those of control group (P<0.05). Additionally, the number of pressing patient-controlled analgesia (PCA) and postoperative opioid consumption within 24 hours after operation were significantly lower than those in the SAPB groups (P<0.05). There was also an advantage in reducing opioid-related adverse reactions (P<0.05), but there was no statistically significant difference in shortening operative time (P>0.05). Conclusion: SAPB could provide better postoperative analgesia and had more effective advantages in adverse effects after MRM. However, there was no significant advantage in shortening operative time.
Keywords：
serratus anterior plane block; modified radical mastectomy; analgesia; Meta-analysis