Abstract: Objective To investigate the effect of pectointercostal fascial block（PIFB)PECSⅡ block-general anesthesia on hemodynamics and stress response in patients undergoing modified radical mastectomy for breast cancer.Methods A total of 95 patients with breast cancer who underwent modified radical mastectomy in the hospital from November 2021 to November 2023 were enrolled in this study.They were divided into the control group (n=46) and the observation group (n=49) according to the anesthesia mode.The control group received PECS Ⅱ block general anesthesia and the observation group received PIFB-PECS Ⅱ block-general anesthesia.The dosage of remifentanil,the dosage of cisatracurium,recovery time,tracheal extubation time,postoperative analgesia pump compression times,VAS scores,hemodynamics (HR,MAP),oxidative stress response (SOD,CAT,MDA),and hyperthermia were compared between the two groups Susceptibility to MMSE score and adverse reactions.Results The dosage of remifentanil,dosage of cisatracurium,effective pressing times of analgesia pump within 48 h,wake-up time,tracheal extubation time and time to postoperative first pressing in the observation group were lower and shorter than those in the control group (P<0.05).The observation group had lower VAS scores than the control group after surgery (P<0.05).The HR of after anesthesia induction (T1),at tracheal intubation (T2),at the beginning of surgery (T3) and at the end of surgery (T4) in the observation group was (78.45±6.12) times /min,(100.28±11.54) times /min,(103.90±14.82) times /min and (93.66±9.17) times /min,respectively,which were lower than the control group [(84.66±7.04) times /min,(112.33±13.28) times /min,(122.44±17.06) times /min and (106.26±11.03) times /min,respectively].MAP of T1,T2,T3 and T4 in the observation group were (67.73±4.09) mmHg,(75.22±9.51) mmHg,(90.76±10.77) mmHg and (82.50±8.63) mmHg,respectively,the control groups were (70.10±5.66) mmHg, (82.62±10.17) mmHg, (96.43±12.59) mmHg and (90.82±11.04) mmHg,respectively.There was a statistically significant difference between the two groups (P<0.05). The levels of SOD, CAT and MDA in both groups at 24 hours and 72 hours after the operation were all higher than those before the operation (P<0.05).The SOD levels in the observation group were (83.22±15.44) nU/ml and (77.41±10.39) nU/ml at 24h and 72h after operation.It was lower than that of the control group, which was (90.40±18.23) nU/ml and (82.80±13.18) nU/ml.The CAT scores of observation group were (16.20±5.03) kU/L and (14.12±3.27) kU/L at 24h and 72h after operation,which were lower than those of control group [(20.75±6.57) kU/L and (17.06±4.35) kU/L].The MDA levels in the observation group were (5.12±1.33) mmol/L and (3.23±0.76) mmol/L at 24h and 72h after surgery,which were lower than those in the control group [(6.03±2.24) mmol/L and (4.88±1.05) mmol/L],and the differences were statistically significant (all P<0.05).The MMSE scores of the observation group were (28.01±1.35) and (28.46±1.39),which were higher than those of the control group [(26.44±1.08) and (27.36±1.23)] (P<0.05).Conclusion Applying PIFB-PECS Ⅱ block-general anesthesia in modified radical mastectomy for breast cancer can maintain hemodynamic stability,reduce oxidative stress and alleviate the damage to cognitive function,with high safety.

Key words: modified radical mastectomy for breast cancer, pecto-intercostal fascial block, pectoral nerves Ⅱ block, general anesthesia, hemodynamics, stress response