[1]汪家鹏,张庆梅,夏晓琼,等.艾司氯胺酮联合前锯肌及胸横肌平面阻滞对乳腺癌患者术后抑郁的干预[J].医学信息,2024,37(06):102-106.[doi:10.3969/j.issn.1006-1959.2024.06.017]
　WANG Jia-peng,ZHANG Qing-mei,XIA Xiao-qiong,et al.Intervention of Esketamine Combined with Serratus Anterior and Transverse Thoracic Muscle Plane Block on Postoperative Depression in Patients with Breast Cancer[J].Journal of Medical Information,2024,37(06):102-106.[doi:10.3969/j.issn.1006-1959.2024.06.017]
点击复制

艾司氯胺酮联合前锯肌及胸横肌平面阻滞对乳腺癌患者术后抑郁的干预()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年06期
页码:
102-106
栏目:
论著
出版日期:
2024-03-15

文章信息/Info

Title:
Intervention of Esketamine Combined with Serratus Anterior and Transverse Thoracic Muscle Plane Block on Postoperative Depression in Patients with Breast Cancer
文章编号:
1006-1959（2024）06-0102-05
作者:
汪家鹏; 张庆梅; 夏晓琼; 等
（安徽医科大学附属巢湖医院麻醉科，安徽 巢湖 238000）
Author(s):
WANG Jia-peng; ZHANG Qing-mei; XIA Xiao-qiong; et al.
(Department of Anesthesia,Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui,China)
关键词:
艾司氯胺酮; 前锯肌阻滞; 胸横肌平面阻滞; 术后抑郁
Keywords:
Esketamine; Serratus anterior muscle plane block; Transverse thoracic muscle block; Postoperative depression
分类号:
R614；R737.9
DOI:
10.3969/j.issn.1006-1959.2024.06.017
文献标志码:
A
摘要:
目的 探讨艾司氯胺酮联合前锯肌及胸横肌平面阻滞对乳腺癌患者术后抑郁的干预。方法 选择2021年10月-2023年2月我院乳腺癌根治术患者66例，采用随机数字表法分为S、C两组，每组33例。所有患者均行前锯肌及胸横肌平面阻滞，C组为空白对照组，S组分别在麻醉诱导、术中、术后加入艾司氯胺酮。比较两组不同时间[术前1天（T0.5）、术后3天（T1）、术后7天（T2）和1个月（T3）]汉密尔顿抑郁评分量表（HAMD-17）评分，术前（T0）、T0.5、T1、T2匹兹堡睡眠质量指数量表（PSQI）评分和T0.5、T1、T2视觉模拟量表（VAS）评分，T0、T0.5、T1血清脑源性神经营养因子（BDNF）和5-羟色胺（5-HT）浓度，记录手术时间、有无恶心呕吐。结果 S组T1、T2和T3 HAMD-17评分低于C组（P＜0.05）；S组T0.5、T1、T2 PSQI评分低于C组（P＜0.05）；S组T0.5、T1的血清BDNF和5-HT水平浓度高于C组（P＜0.05）；S组与C组T0.5、T1和T2的VAS评分以及手术时间、有无恶心呕吐的发生率比较，差异无统计学意义（P＞0.05）。结论 艾司氯胺酮联合前锯肌及胸横肌平面阻滞对于乳腺癌术后患者可以减少抑郁的发生率，并改善患者术后睡眠质量。
Abstract:
Objective To investigate the effect of esketamine combined with serratus anterior and transverse thoracic plane block on postoperative depression in patients with breast cancer.Methods A total of 66 patients undergoing radical mastectomy in our hospital from October 2021 to February 2023 were selected and divided into group S and group C by random number table method, with 33 patients in each group. All patients underwent anterior serratus and transverse thoracic muscle plane block. Group C was the blank control group, and group S was added with esketamine during anesthesia induction, intraoperative and postoperative. The Hamilton Depression Scale (HAMD-17) score at different time points [1 day before operation (T0.5), 3 days after operation (T1), 7 days after operation (T2) and 1 month after operation (T3)], Pittsburgh Sleep Quality Index (PSQI) scores at T0, T0.5, T1 and T2, Visual Analogue Scale (VAS) score at T0.5, T1 and T2, serum brain-derived neurotrophic factor (BDNF) and 5-hydroxytryptamine (5-HT) concentrations at T0, T0.5 and T1 were compared between the two groups. The operation time, nausea and vomiting were recorded.Results The HAMD-17 score of group S at T1, T2 and T3 were lower than those of group C (P<0.05). The PSQI scores at T0.5, T1 and T2 in group S were lower than those in group C (P<0.05). The serum levels of BDNF and 5-HT at T0.5 and T1 in group S were higher than those in group C (P<0.05). There was no significant difference in VAS scores at T0.5, T1 and T2, operation time and incidence of nausea and vomiting between group S and group C (P>0.05).Conclusion Esketamine combined with serratus anterior and transverse thoracic plane block can reduce the incidence of depression and improve the quality of sleep in patients after breast cancer surgery.

参考文献/References:

[1]Zhi D,Ma X,Lv L,et al.Abnormal Dynamic Functional Network Connectivity and Graph Theoretical Analysis in Major Depressive Disorder [J].Annu Int Conf IEEE Eng Med Biol Soc,2018,2018:558-561.[2]Wilkinson L,Gathani T.Understanding breast cancer as a global health concern [J].Br J Radiol,2022,95(1130):20211033.[3]Borah RK,Barman B,Choudhury HK.Envisioning the financial and psychological hardships of cancer [J].Indian J Public Health,2022,66(2):190-192.[4]Hammen C.Risk Factors for Depression: An Autobiographical Review [J].Annu Rev Clin Psychol,2018,14:1-28.[5]Yang Y,Sun H,Luo X,et al.Network connectivity between fear of cancer recurrence, anxiety, and depression in breast cancer patients [J].J Affect Disord,2022,309:358-367.[6]Aslan G,Avc?覦 O,Gündoｇdu O,et al.The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery [J].Turk J Surg,2020,36(4):374-381.[7]Swainson J,Thomas RK,Archer S,et al.Esketamine for treatment resistant depression [J].Expert Rev Neurother,2019,19(10):899-911.[8]Smith K.Mental health: a world of depression [J].Nature,2014,515(7526):181.[9]Li Q,Lin Y,Xu Y,et al.The impact of depression and anxiety on quality of life in Chinese cancer patient-family caregiver dyads, a cross-sectional study [J].Health Qual Life Outcomes,2018,16(1):230.[10]Ghoneim MM,O’haraM W.Depression and postoperative complications: an overview [J].BMC Surg,2016,16:5.[11]Kehlet H,Wilmore DW.Evidence-based surgical care and the evolution of fast-track surgery[J].Ann Surg,2008,248(2):189-198.[12]White PF,Kehlet H,Neal JM,et al.The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care [J].Anesth Analg,2007,104(6):1380-1396.[13]Xiao YK,She SZ,Xu LX,et al.Serratus Anterior Plane Block Combined with General Analgesia and Patient-Controlled Serratus Anterior Plane Block in Patients with Breast Cancer: A Randomized Control Trial [J].Adv Ther,2021,38(6):3444-3454.[14]Patel SY,Evans RM,Garcia Getting RE,et al.Pectoral Nerve and Transverse Abdominis Plane Block in a Patient Undergoing Mastectomy With Transverse Rectus Abdominis Muscle Flap: A Case Report [J].A A Case Rep,2017,8(8):210-122.[15]Blanco R,Parras T,Mcdonnell JG,et al.Serratus plane block: a novel ultrasound-guided thoracic wall nerve block [J].Anaesthesia,2013,68(11):1107-1113.[16]Baytar MS,Y?覦lmaz C,Karasu D,et al.Comparison of ultrasonography guided serratus anterior plane block and thoracic paravertebral block in video-assisted thoracoscopic surgery: a prospective randomized double-blind study [J].Korean J Pain,2021,34(2):234-240.[17]Xie C,Ran G,Chen D,et al.A narrative review of ultrasound-guided serratus anterior plane block [J].Ann Palliat Med,2021,10(1):700-706.[18]Hamed MA,Boules ML,Sobhy MM,et al.The Analgesic Efficacy of Ultrasound-Guided Bilateral Transversus Thoracic Muscle Plane Block After Open-Heart Surgeries: A Randomized Controlled Study [J].Journal of Pain Research,2022,15:675-682.[19]Lin FB,Hou DR,Tang QP.Research progress of depression and the application of esketamine [J].Journal of Southern Medical University,2016,37(4):567-inside back cover.[20]Liu P,Li P,Li Q,et al.Effect of Pretreatment of S-Ketamine On Postoperative Depression for Breast Cancer Patients [J].J Invest Surg,2021,34(8):883-888.[21]Ju HB,Kang EC,Jeon DW,et al.Associations Among Plasma Stress Markers and Symptoms of Anxiety and Depression in Patients with Breast Cancer Following Surgery [J]. Psychiatry Investig,2018,15(2):133-140.[22]Shabbir F,Patel A,Mattison C,et al.Effect of diet on serotonergic neurotransmission in depression [J].Neurochem Int,2013,62(3):324-329.

相似文献/References:

[1]曹凤林,江岸柳.甲苯磺酸瑞马唑仑联合艾司氯胺酮静脉麻醉在内镜下逆行胰胆管造影术中的应用[J].医学信息,2022,35(17):123.[doi:10.3969/j.issn.1006-1959.2022.17.033]
　CAO Feng-lin,JIANG An-liu.Application of Intravenous Anesthesia of Remazolam Tosylate Combined with Esketamine in Endoscopic Retrograde Cholangio-pancreatography[J].Journal of Medical Information,2022,35(06):123.[doi:10.3969/j.issn.1006-1959.2022.17.033]
[2]缪永江,王 煜,胡 萍,等.小剂量艾司氯胺酮在腹腔镜手术全身麻醉中的镇痛效果分析[J].医学信息,2023,36(15):140.[doi:10.3969/j.issn.1006-1959.2023.15.029]
　MIAO Yong-jiang,WANG Yu,HU Ping,et al.Analysis of Analgesic Effect of Low-dose Esketamine in General Anesthesia for Laparoscopic Surgery[J].Journal of Medical Information,2023,36(06):140.[doi:10.3969/j.issn.1006-1959.2023.15.029]
[3]程李夏,马贵芬,夏晓琼.亚麻醉剂量艾司氯胺酮联合TAPB对老年腹部手术患者神经认知功能的影响[J].医学信息,2024,37(04):83.[doi:10.3969/j.issn.1006-1959.2024.04.015]
　CHENG Li-xia,MA Gui-fen,XIA Xiao-qiong.Effect of Subanesthetic Dose of Esketamine Combined with TAPB on Neurocognitive Function in Elderly Patients Undergoing Abdominal Surgery[J].Journal of Medical Information,2024,37(06):83.[doi:10.3969/j.issn.1006-1959.2024.04.015]
[4]林容木,章 锐,雷程雯,等.艾司氯胺酮联合帕瑞昔布钠对腹腔镜胃肠道恶性肿瘤根治术老年患者术后恢复质量的影响[J].医学信息,2024,37(06):84.[doi:10.3969/j.issn.1006-1959.2024.06.014]
　LIN Rong-mu,ZHANG Rui,LEI Cheng-wen,et al.Effect of Esketamine Combined with Parecoxib Sodium on Postoperative Recovery Quality in Elderly Patients Undergoing Laparoscopic Radical Resection of Gastrointestinal Malignant Tumor[J].Journal of Medical Information,2024,37(06):84.[doi:10.3969/j.issn.1006-1959.2024.06.014]

更新日期/Last Update: 1900-01-01