Objective To evaluate the
efficacy of transverse thoracic
muscle plane-
thoracic nerve block combined with
general anesthesia when used for
modified radical mastectomy .
Methods Sixty
female patients , of American Society of
Anesthesiologists physical statusⅠ or Ⅱ,
aged 45-63 yr, weighing 48-72 kg, scheduled for elective
modified radical mastectomy , were divided into 3 groups ( n=20 each) using a random number table
method: thoracic nerve block-
general anesthesia group ( group P+G ) , transverse thoracic
muscle plane-
thoracic nerve block-
general anesthesia group ( group T+P+G) and
general anesthesia group ( group G ) .
Anesthesia was induced with
midazolam ,
propofol ,
fentanyl and cisatracurium and maintained with
sevoflurane ,
fentanyl and cisatracurium.
Thoracic nerve block typeⅠ and Ⅱ was per-formed after implanting
laryngeal mask airway in group P+G. Transverse thoracic
muscle plane block was performed after performing
thoracic nerve block typeⅠandⅡin group T+P+G.
Flurbiprofen 50 mg was in-travenously injected after operation as a rescue
analgesic to maintain the Visual Analogue Scale score≤3. The
consumption of
opioids , emergence
time and
time for removal of the
laryngeal mask airway were recor-ded. Ramsay sedation score was recorded
at 10 min after removal of the
laryngeal mask airway . The require-ment for rescue
analgesia ,
time of passing
flatus and development of
nausea and
vomiting within 24 h after operation were recorded. Results Compared with group G, the emergence
time ,
time for removal of the
laryngeal mask airway and
time of passing
flatus were significantly shortened, and the Ramsay sedation score,
consumption of
fentanyl and requirement for rescue
analgesia were decreased in P+G and T+P+G groups ( P<0. 05) , and the
incidence of
nausea and
vomiting was significantly decreased in group T+P+G ( P<0. 05) . Compared with group P+G, the
time for removal of the
laryngeal mask airway and
time of pass-ing
flatus were significantly shortened, the
consumption of
fentanyl was decreased ( P<0. 05) , and no sig-nificant change was found in the requirement for rescue
analgesia or
incidence of
nausea and
vomiting in group T+P+G ( P>0. 05) . Conclusion Transverse thoracic
muscle plane-
thoracic nerve block combined with
general anesthesia can provide satisfactory perioperative
analgesia and is helpful in improving
prognosis for the
patients undergoing
modified radical mastectomy .