Effects of serratus anterior plane block and thoracic paravertebral block on postoperative analgesia and stress response in breast cancer patients

Abstract

Objective To investigate the influence of thoracic paravertebral block(TPVB) and serratus anterior plane block(SAPB) on postoperative analgesia and stress response in patients with breast cancer. Methods A total of 92 patients who planned to receive radical mastectomy from January 2020 to December 2021 in Huizhou Municipal Central Hospital were selected as study objects. All the patients were divided into SAPB group(SAPB + laryngeal mask general anesthesia, n=31), TPVB group(TPVB + laryngeal mask general anesthesia, n=31) and general anesthesia group(laryngeal mask general anesthesia, n=30) according to random number method. The postoperative pain and analgesic effect were compared among the three groups. The stress response indexes ［interleukin(IL)-10, IL-6 and malondialdehyde(MDA)］before and 24 hours after operation were compared among the three groups. The adverse reactions of the three groups were recorded. Results The VAS scores at 12 h, 24 h, 48 h and 72 h after operation were as follows: simple anesthesia group＞SAPB group＞TPVB group(P＜0.05). The dosage of sufentanil and the effective press times of patient-controlled intravenous analgesia(PCIA) within 48 hours after operation were as follows: simple anesthesia group＞SAPB group＞TPVB group(P＜0.05). The levels of serum IL-10, IL-6 and MDA at 24 h after operation were as follows: simple anesthesia group＞SAPB group＞TPVB group(P＜0.05). Conclusion TPVB is superior to SAPB in postoperative analgesia for breast cancer, which can effectively relieve postoperative pain of patients, prolong the effective duration of analgesia, reduce the dose of analgesic drugs, and alleviate the stress reaction of the body.

Keywords

• radical mastectomy
• serratus anterior plane block
• thoracic paravertebral block
• postoperative analgesia