Comparison Of Different Methods Of Anterior Serratus Block In Modified Radical Mastectomy For Breast Cancer

Objective: To compare the effect of different anterior serratus block on postoperative rehabilitation of breast cancer patients undergoing modified radical mastectomy.Methods: 90 patients with modified breast cancer underwent modified radical mastectomy were selected.They were gender women,body mass index(BMI)18~24kg/m3,age 40~60,ASA grade I or II.90 patients were randomly divided into three groups with 40 cases in each group: Conventional serratus anterior plane block group(CSAB),blank control group(BCG)and new serratus anterior plane block group(NSAB).Patients in CSAB group received Blanco’s serratus anterior plane block and 20 ml of 0.5% ropivacaine before anesthesia induction;patients in NSAB group received frenco anterior saw muscle block and 20 ml of 0.5% ropivacaine before anesthesia induction;The blank control group was not pretreated with nerve block before anesthesia induction.The three groups of patients used standardized anesthesia induction,intraoperative pump injection of propofol,remifentanil and CIS atracurium to maintain anesthesia,and all patients used sufentanil for patient-controlled intravenous analgesia after operation.Record the changes of noninvasive blood pressure and heart rate immediately before and 5 minutes after skin incision,calculate the difference △ SBP and △ HR,and record the dosage of remifentanil during operation;Visual analogue pain scores at rest and during exercise were recorded at 1H,6h,12 h,24h and 48 h after operation;The scores of qor-15 questionnaire were recorded 24 hours later;The consumption of sufentanil at0 ~ 12 h,12 ~ 24 h and 24 ~ 48 h after operation was recorded.Results: the consumption of remifentanil in csab group and nsab group was less than that in blank control group,but there was no significant difference between nsab group and csab group;Sufentanil consumption at 0 ~ 12 h and 12 ~ 24 h after operation: NSAB< CSAB < BCG,but there was no significant difference among the three groups at 24 ~ 48 h after operation.The total sufentanil consumption after operation:NSAB < CSAB <BCG.Postoperative qor-15 score: NSAB > CSAB >BCG;The VAS scores of resting and exercise at 1h and 6h after operation in nsab group and csab group were lower than those in blank control group,but there was no significant difference between the two groups;There was no significant difference in VAS scores at exercise and rest at 12 h,24h and 48 h after operation.Conclusion: compared with Conventional serratus anterior plane block(Blanco’s serratus anterior plane block),New serratus anterior plane block(Flanco’s serratus anterior plane block)can effectively improve the quality of postoperative recovery and reduce the consumption of opioids in patients undergoing breast cancer modified radical mastectomy.