Affiliation:
1. Graduate School of Inner Mongolia Medical University, Hohhot, China
2. Department of Anesthesiology, Xing’anmeng People’s Hospital, Ulanhot, China
3. Department of Anesthesiology, Inner Mongolia Forth Hospital, Hohhot, China
4. Department of Anesthesiology, Peking University Cancer Hospital Inner Mongolia Hospital, Hohhot, China.
Abstract
Background:
Combining hydromorphone with ropivacaine in ultrasound-guided erector spinae plane blocks enhances postoperative analgesia and reduces interleukin-6 expression in breast surgery patients.
Methods:
In this study, breast cancer patients undergoing modified radical mastectomy were randomized into 3 groups for anesthesia (30 patients in each group): standard general (group C), Erector Spinae Plane Block (ESPB) with ropivacaine (group R), and ESPB with ropivacaine plus hydromorphone (group HR). Diagnosis: Breast cancer patients. Postsurgery, pain levels, IL-6, anesthetic doses, additional analgesia needs, and recovery milestones were compared to evaluate the efficacy of the ESPB enhancements.
Results:
The 3 groups were not significantly different in baseline characteristics, operation time, number of cases with postoperative nausea, and serum IL-6 concentrations at T1 (the time of being returned to the ward after surgery). At T2 (at 6:00 in the next morning after surgery), the serum IL-6 concentration in group HR was significantly lower than that in groups R and C (P < .05); the intraoperative doses of remifentanil, sufentanil, and propofol were significantly lower in groups HR and R than those in group C (P < .05); Groups HR and R had significantly lower visual analog scale scores at T3 (4 hours postoperatively), T4 (12 hours postoperatively), and T5 (24 hours postoperatively) than those in group C (P < .05); the proportions of patients receiving postoperative remedial analgesia were significantly lower in groups HR and R than in group C (P < .05); groups HR and R had significantly lower proportions of patients with postoperative nausea than group C (P < .05); the time to the first anal exhaust and the time to the first ambulation after surgery were significantly shorter in groups HR and R than those in group C (P < .05).
Conclusion:
Hydromorphone combined with ropivacaine for ESPB achieved a greater postoperative analgesic effect for patients receiving MRM under general anesthesia. The combined analgesia caused fewer adverse reactions and inhibited the expression level of the inflammatory factor IL-6 more effectively, thereby facilitating postoperative recovery. ESPB using hydromorphone with ropivacaine improved pain control post-MRM, reduced adverse effects, and more effectively suppressed IL-6, enhancing recovery.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference17 articles.
1. Prophylaxis of postoperative nausea and vomiting in patients scheduled for breast surgery.;Fujii;Clin Drug Investig,2006
2. Effect of proinflammatory factors TNF-α,IL-1β, IL-6 on neuropathic pain.;Li;Zhongguo Zhong Yao Za Zhi,2017
3. A large randomized trial: effects of Mindfulness-Based Stress Reduction (MBSR) for breast cancer (BC) survivors on salivary cortisol and IL-6.;Lengacher;Biol Res Nurs,2019
4. A survey on psychological problems in breast cancer patients after surgery and nursing measures.;Huang;Guide China Med,2022
5. Perioperative breast analgesia: a qualitative review of anatomy and regional techniques.;Woodworth;Reg Anesth Pain Med,2017