在接受乳腺切除术的患者中，肩部疼痛很常见，且限制了肩关节的活动能力，对他们的生活质量产生了负面影响。胸部皮肤神经阻滞（PECs）在提供术后镇痛方面已经证明了其功效。我们假设这些神经阻滞治疗可以改善接受乳腺切除手术的患者的肩关节活动。这项前瞻性、随机、双盲对照试验纳入了女性乳腺癌患者，并计划接受乳腺切除手术的参与者。参与者随机分配到传统镇痛组或干预组。在干预组中，在乳腺切除术后皮肤缝合前进行PECs II阻滞。本研究的主要结果是在不同位置（前抬、外旋、向外展、内旋和交叉收紧）上评估肩关节活动比率，记录手术前、术后24小时、48小时和72小时的间隔，并在1个月、2个月、3个月和6个月时进行随访。最终分析纳入了59名参与者。接受PECs II阻滞的乳腺切除术患者在外旋和向外展的肩关节活动方面显示出更好的恢复，从术后早期到术后6个月均如此。肩部前抬在术后早期也显示出更好的恢复，术后1个月后观察到统计学上的显著差异。然而，在内旋和收紧肩部活动方面，两组之间没有显著差异。与传统镇痛相比，术中直视下的胸部神经阻滞可以在乳腺癌患者的乳腺切除术后增强肩关节的前抬、外旋和向外展能力。版权所有 © 2023 The Authors. Elsevier Ltd. 发布。保留所有权利。

Shoulder pain is common among mastectomy patients, with limiting shoulder mobility and negatively affecting their quality of life. Pectoral nerve blocks (PECs) have demonstrated efficacy in providing postoperative analgesia. We hypothesized that these nerve blocks could improve shoulder movement in patients undergoing mastectomy.This prospective, randomized, double-blind controlled trial enrolled female participants diagnosed with breast cancer and scheduled for mastectomy. Participants were randomly assigned to either the conventional analgesia group or the intervention group. In the intervention group, a PECs II block was applied prior to skin closure following a mastectomy. This study's primary outcome was the assessment of shoulder movement ratios in 5 different positions (forward elevation, external rotation, arm abduction, internal rotation, and cross-body adduction), which were recorded before surgery, at 24-h, 48-h, and 72-h intervals postoperatively, with follow-up at 1 month, 2 months, 3 months, and 6 months.A total of 59 participants were included in the final analysis. Patients who underwent mastectomy with PECs II block exhibited better shoulder movement in terms of external rotation and arm abduction from the early post-surgery up to 6 months postoperatively. Shoulder forward elevation also showed superior gains during the early postoperative period, with statistical significance observed after 1 month following the surgery. However, no significant differences were found between the two groups in terms of internal rotation and adduction movements of the shoulder.Compared to conventional analgesia, intraoperative pectoral nerve block under direct vision enhances shoulder mobility in forward elevation, external rotation, and arm abduction after mastectomy in breast cancer patients.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.