Application Effect of Pecs Ⅱ-Based Multimodal Analgesia in Mastectomy and Its Impact on Postoperative Pain-stress Factors
YANG Guangyu
QI Fuwei
ZHENG Zhong
LI Ke
FEI Fan
WANG Min
Abstract：Objective To explore the application effect of pectoral nerve block Ⅱ(Pecs Ⅱ)-based multimodal anal-gesia in mastectomy and its impact on postoperative pain-stress factors.Methods A total of 90 adult female patients with breast cancer who underwent mastectomy from April 2020 to March 2022 were selected and divided into general anesthesia combined with Pecs Ⅱ-based multimodal analgesia group(PGN group,n = 30),general anesthesia combined with Pecs Ⅱ group(GN group,n =30),and general anesthesia alone group(G group,n =30)by random number table method.Periop-erative indexes,pain-stress factors[neuropeptide Y(NPY),prostaglandin E2(PGE2),angiotensin Ⅰ(AngⅠ),cortisol(Cor))],pain degree[visual analogue scale(VAS)score],sedation degree(Ramsay score),quality of life[European Organization for Research and Treatment(EORTC)Quality of Life Questionnare-Core 30(QLQ-C30)score],functional sta-tus[Key Performance Score(KPS)score]and incidence of adverse reactions were compared among the three groups.The in-cidence of post-mastenctomy pain syndrome(PMPS)was recorded in the three groups.Results There was no significant difference in duration of operation,intraoperative blood loss and duration of anesthesia among the three groups(P>0.05).The amount of opioid in PGN group was lower than that in GN and G group at 48 h after surgery,and the length of hospital stay was shorter than that in GN and G group(P<0.01).The levels of serum NPY,PGE2,AngⅠand Cor in PGN group at 12,24 and 48 h after surgery were lower than those in GN group and G group(P<0.01).VAS scores and Ramsay scores in PGN group at 2,8,12,24 and 48 h after surgery were lower than those in GN group and G group(P<0.01).The EORTC QLQ-C30 score and KPS score of PGN group were higher than those of GN group and G group at 3 and 6 months after operation(P<0.01).There was no significant difference in the incidence of adverse reactions among the three groups at 48 h after op-eration(P>0.05).The incidence of PMPS in PGN group was lower than that in GN group and G group at6 months after op-eration(P<0.05).Conclusion Pecs Ⅱ-based multimodal analgesia can improve analgesia and sedation after mastectomy,inhibit pain-stress factors effectively,reduce the incidence of PMPS,and help improve patients'quality of life.
Keywords：Breast neoplasmsMastectomyPectoral nerve block ⅡNeuropeptide YAngiotensin ICortisolDe-gree of sedationPain syndrome
Publication Date：2023-12-22
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 110-115 )