Clinical Study Of The Effects Of Pectoral Nerve Block On Postoperative Recovery Of Patients After Breast Surgery

ObjectiveFor investigating the influence of pectoral nerves(Pecs)block on the incidence rate of postoperative chronic pain and recovery after having breast surgery,and providing a reference for the clinical postoperative analgesia,the occurrence of postoperative recovery and chronic pain after receiving ultrasound-guided Pecs block was observed,meanwhile the recovery of using ropivacaine only and combined with Dexmedetomidine(DEX)was compared.Methods135 patients undergoing general anesthesia segment mastectomy were randomly divided into 3 groups:Control Group(Group C),Ropivacaine only Pecs Group(Group P),Ropivacaine combined with Dexmedetomidine Pecs Group(Group D).Intervening Measure:injecting 30ml of 0.16%Ropivacaine to the patients from Group P who accept the Pecs block after the operation;giving 30ml of 0.16%Ropivacaine combined with Dexmedetomidine 1.0?g/Kg to the patients from Group D who accept the Pecs block after the operation;giving nothing to the patients from Group C who accept with routine analgesia on demand in ward(VAS>4,oral 100mg of Tramadol Hydrochloride Sustained Release Tablets).Vital signs,drug use,fluid input volume,operation time,tumor were recorded during operation.Moreover,visual analogue score(VAS)evaluation was implemented on hour 6(T1),day 1(T2),day 2(T3),week 1(T4),month 1(T5)and month 3(T6)after operation;Ramsay,incidence of nausea and vomiting and analgesia dosage in ward evaluation was implemented on hour 6 after operation;DSIS evaluation was implemented on day 1 after operation;QoR-40 evaluation was implemented on day 1 before operation and day 1 after operation.ResultsThere was no significant differences in age,height,weight,body mass index(BMI),ASA classification and tumor of the 3 groups(P>0.05).There was also no significant differences among 3 groups in opioid dosage and operation time(P>0.05).There were statistical differences in comparing the VAS evaluation results on hour 6,day 1,day 2,week 1,month 1 and month 3 of the 3 groups after operation(P<0.05),and there was no significant differences on month 3 of the 3 groups after operation(P>0.05);There was no significant differences among the 3 groups in comparing the incidence rate of chronic pain,though the incidence rate of chronic pain of Group P and Group D was lower than Group C(P>0.05).The comparation of DSIS evaluation results(hour 6 after operation)among different groups showed statistical significance(P<0.05).In this research,there was no significant differences among 3 groups in comparing the incidence rate of PONV(P>0.05).There were statistical differences in comparing the physical comfort,emotions,physical independence,patient support,pain and QoR-40 score of the 3 groups before operation with these after operation(P<0.05),The results showed that there was no significant differences in the indicators of the preoperative patients among the 3 groups(P>0.05),there was no significant differences in postoperative physical independence evaluation results of the 3 groups(P>0.05),the rest of the indicators of the postoperative patients among the 3 groups was statistical differences(P<0 05),compared with Group P,only the emotional evaluation results of Group D after operation was statistical differences(P<0.05).In this research,there were statistical differences in comparing the QoR-40 evaluation results of Pecs Groups and Control Group after operation(P<0.05),but there was no significant differences between the Ropivacaine Only and Ropivacaine combined with Dexmedetomidine Pecs Group(P>0.05).ConclusionsThere was no significant differences among the 3 groups in comparing the incidence rate of chronic pain,though the incidence rate of chronic pain of Group P and Group D was lower than Group C(P>0.05),showed the Pecs block in breast surgery could prevent the incidence of postoperative acute pain,and could not reduce the incidence rate of postoperative chronic pain.Pecs block could promote postoperative recovery after having breast surgery,and compared with the 0.16%Ropivacaine only Pecs Group,Ropivacaine combined with Dexmedetomidine 1.0 P g/Kg Pecs Group had no significant advantage.