Effects Of Different Concentrations Of Ropivacaine Serratus Anterior Plane Block On Chronic Pain Syndrome After Breast Cancer Surgery

Objective:To observe the effects of different concentrations of ropivacaine serratus anterior plane block(SAPB)on chronic pain syndrome after breast cancer surgery.Methods:120 patients undergoing modified radical mastectomy in our hospital for breast cancer during March 2020 to March 2022 were selected.They were gender women,BMI18~24 kg/m3,age 40~60,ASA grade I or II.Patients were randomly divided into 4 groups: the general anesthesia group(group A)and the 0.25% ropivacaine SAPB combined with general anesthesia group(group R1),the 0.375% ropivacaine SAPB combined with general anesthesia group(group R2),the 0.5% ropivacaine SAPB combined with general anesthesia group(group R3),30 cases in each group.All four groups received endotracheal intubation and general anesthesia,Group R1、Group R2 and Group R3 received ultrasound-guided SAPB after anesthesia induction,and 0.25%、0.375% and 0.5% ropivacaine 30 ml was injected.Observational index: The scores of the MOS item short from health survey(SF-36),Mc Gill pain questionaire(SF-MPQ)and Beck Depression Inventory(BDI),and the incidence of chronic pain in the four groups were recorded at 3,6,9 and 12 month after surgery.Results:1.Comparison of PMPS incidence3 and 12 months after surgery,the incidence of PMPS in R1,R2 and R3 groups were lower than that in group A,and the incidence of PMPS in R2 and R3 groups were lower than that in R1 group(P<0.05),and there was no significant difference between R2 and R3 groups.6 months after surgery,the incidence of PMPS in R1,R2 and R3 groups were lower than that in group A,and the R3 group had the lowest incidence of PMPS among the three groups(P<0.05),and there was no significant difference between R1 and R2 groups.9 months after surgery,the incidence of PMPS in R1,R2 and R3 groups were lower than that in group A,and the R2 group had a relatively low incidence of PMPS compared to the R1 group,and the R3 group had the lowest incidence of PMPS among the three groups(P<0.05).2.The SF-36:3 months after surgery,the scores of PF,BP,GH,VT,MH were higher in the R3 group than in group A,R1 and R2,then R2 ranked second and R1 ranked third are both higher than Group A(P<0.05).The SF scores of R2 and R3 highest among the four groups,while Group A scored lowest(P<0.05),and there were no manifest correlation differences between R2 and R3.There were no significant differences between RP and RE groups.6 months after surgery,the scores of PF,BP,GH,VT,SF,RE,MH were higher in R3 than in group A,R1 and R2,R2 group was higher than group A and R1,and group R1 was higher than group A(P<0.05).There was no statistically significant difference between the four groups of RP.9 and 12 months after surgery,the scores of PF,RP,BP,GH,VT,SF,RE,and MH were all higher in R2 and R3 than in A and R1,and R1 higher than in A(P<0.05),and there was no significant difference between R2 and R3.3.The MPQ:The R1,R2 and R3 group were lower than the A group,and the R2 group and R3 group were lower than the R1 group at 3,6,9 and 12 month after surgery(P<0.05).4.The BDI:R2 and R3 were lower than those in group A and R1 at 3,6,9 and 12 months after surgery,and lower in group A(P<0.05)in R1 group,and there was no significant difference between R2 and R3 groups.Conclusions:The implementation of ultrasound-guided serratus anterior plane block for modified radical mastectomy of breast cancer can reduce the incidence of chronic pain syndrome after breast cancer surgery and improves the quality of life of patients after surgery.However,0.375% ropivacaine is the most suitable concentration.