甘肃医药2026，Vol.45Issue(7)：604-607,615,5.DOI:10.15975/j.cnki.1004-2725.2026.07.007
超声引导下前锯肌平面阻滞与椎旁神经阻滞在乳腺癌保乳手术中镇痛效果的对照研究
A comparative study of ultrasound-guided serratus anterior plane block and thoracic paravertebral block for analgesia in breast-conserving surgery
摘要
Abstract
Objective:To compare the analgesic efficacy and safety of serratus anterior plane block(SAPB)and thoracic paraverte bral block(TPVB)in patients undergoing breast-conserving surgery for breast cancer.Methods:This prospective randomized controlled study included 120 patients scheduled for breast-conserving surgery for breast cancer in the Department of Breast Surgery,Gansu Provincial Cancer Hospital,between August 2024 and October 2025.Patients were randomly assigned to the SAPB group or TPVB group(60 patients in each group).Postoperative resting and movement visual analogue scale(VAS)scores at different time points,opioid consumption,block-related parameters,and adverse events were recorded and analyzed.Results:The resting and movement VAS scores at 6 h and 12 h after surgery were significantly lower in the TPVB group than in the SAPB group[(2.19±0.72 vs 2.68±0.79),(2.07±0.61 vs 2.54±0.83),(3.21±0.84 vs 3.87±0.93),and(3.04±0.79 vs 3.65±0.88),respectively;t=3.551,3.534,4.079,and 3.996;all P<0.05].The proportion of patients requiring rescue analgesia was lower in the TPVB group than in the SAPB group[15.00%(9/60)vs 30.00%(18/60),χ2=3.871,P<0.05].Compared with the SAPB group,the TPVB group had longer block procedure time and sensory block duration,while the mean arterial pressure and heart rate at skin incision were lower[(12.37±2.18)vs(6.84±1.42)min,(13.52±2.13)vs(9.84±1.67)h,(79.83±8.72)vs(84.56±9.47)mmHg,and(73.42±8.47)vs(78.56±9.13)beats/min;t=-16.464,-10.532,2.846,and 3.197;all P<0.05].No significant differences were observed between the two groups in the incidence of adverse reactions,time to first ambulation,or length of hospital stay(P＞0.05).Conclusions:Compared with SAPB,TPVB provided superior postoperative analgesia,reduced opioid consumption,prolonged analgesic duration,and better suppressed the stress response to skin incision.However,TPVB is technically more complex and time-consuming;therefore,both techniques have their own clinical advantages and applicable scenarios.关键词
前锯肌平面阻滞/椎旁神经阻滞/乳腺癌/保乳手术/术后镇痛Key words
serratus anterior plane block/thoracic paravertebral block/breast cancer/breast-conserving surgery/postoperative anal-gesia分类
医药卫生引用本文复制引用
王云,王世博,何平,王海东..超声引导下前锯肌平面阻滞与椎旁神经阻滞在乳腺癌保乳手术中镇痛效果的对照研究[J].甘肃医药,2026,45(7):604-607,615,5.基金项目
1.甘肃省自然科学基金项目(编号:24JRRA696) （编号:24JRRA696）
2.甘肃省联合科研基金重点项目(编号:25JRRA1293) （编号:25JRRA1293）
