Long-acting analgesic medicine for anterior saw muscle plane block and application of long-acting analgesic medicine

Abstract

The invention discloses a long-acting analgesic medicine for anterior saw muscle plane block and application of the long-acting analgesic medicine, and relates to the technical field of biological pharmacy, the long-acting analgesic medicine for anterior saw muscle plane block comprises ropivacaine and methylene blue, the concentration of the ropivacaine is 0.5-1.0%, the concentration of the methylene blue is 0.5-1.0%, and the concentration of the methylene blue is 0.5-1.0%. The concentration of the methylene blue is 0.5%-2.0%; the medicine is used for anterior saw muscle plane block after prosthetic breast augmentation. It is clear for the first time that compared with independent use of ropivacaine, when methylene blue and ropivacaine are used in anterior saw muscle plane block, acute pain in the hospitalization period of prosthetic breast augmentation can be effectively relieved, a stable analgesic effect is provided within 72 hours after an operation, and long-acting analgesia can be achieved; the analgesic medicine has the advantage of low cost; the addition of methylene blue does not increase the occurrence rate of adverse reactions, and the method has good safety and wide application potential.

Description

TECHNICAL FIELD

[0001] The present application relates to the technical field of biopharmaceuticals, and particularly to a long-acting analgesic for anterior serratus plane block and application thereof. BACKGROUND

[0002] Augmentation mammoplasty is one of the most common cosmetic procedures worldwide, with approximately 1.8 million cases performed annually. There are multiple techniques for prosthetic augmentation mammoplasty, among which the axillary approach has the advantage of a concealed incision and minimal damage. However, the study by Urits et al. suggests that the axillary incision may be a potential risk factor for chronic pain after augmentation mammoplasty. In addition, prostheses can cause acute or chronic postoperative pain, which is partly attributed to the placement of the prosthesis under the pectoralis major muscle and the formation of scar tissue around the prosthesis. There is controversy over the optimal analgesic regimen for augmentation mammoplasty, but relying solely on a single analgesic method cannot meet the needs of modern pain management. The analgesic strategies for augmentation mammoplasty can be broadly divided into non-opioid and opioid categories. Non-opioid analgesics, including non-drug therapies such as physical therapy and alternative medicine, as well as non-opioid drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, have been shown to be effective in managing mild to moderate postoperative pain. These methods are widely used for mild to moderate pain due to their safety and accessibility, but their effectiveness in managing severe pain is limited, and risks such as gastrointestinal irritation need to be considered. In contrast, opioid analgesics, including oral opioid drugs and patient-controlled intravenous analgesia (PCIA), are highly effective for severe postoperative pain due to their rapid onset and strong action. However, opioid drugs are not effective for all patients and can cause dizziness, nausea, drowsiness, vomiting, and other anesthesia-related adverse reactions. In addition, due to factors such as medical resource accessibility, medical infrastructure structure, and clinical guidelines, there are regional and clinical practice differences in their use.

[0003] Regional analgesia is widely used in breast plastic surgery due to its strong analgesic effect, fewer side effects, and low risk of opioid dependence, and mainly includes thoracic nerve block (PECS), thoracic nerve type II block (PECS II), anterior serratus plane block (SAPB), erector spinae plane block (ESPB), and intercostal nerve block (ICNB). Lidocaine, ropivacaine, or bupivacaine are commonly used, but due to the short half-life of local anesthetics, it is difficult to provide sustained analgesia after augmentation mammoplasty. Kang confirmed that ropivacaine used for intercostal nerve block was effective for local analgesia after augmentation mammoplasty, although only VAS scores within 120 minutes were recorded, but the authors stated that the maximum duration of action of ropivacaine was 640 ± 68 minutes. David Boccara found that the analgesic effect of ropivacaine was negligible 24 hours after surgery when using intercostal nerve block.

[0004] In addition, the addition of adjuvants has been proven to help prolong the effect of ropivacaine in the clinic. However, the study of adding another long-acting analgesic to local anesthetics has not been fully developed. Methylene blue has the advantages of safety, low cost and easy availability. For example, in China, the cost of a single combined block is about 5 dollars, while the cost of liposomal bupivacaine is about 70 dollars.

[0005] Therefore, it is of great significance in the clinic to develop a drug that can provide better long-acting analgesic effect and is low in cost. SUMMARY

[0006] The technical problem to be solved by the present application is to provide a long-acting analgesic drug for anterior serratus plane block and its application.

[0007] To solve the above technical problems, the technical solutions adopted by the present application are as follows.

[0008] A long-acting analgesic drug for anterior serratus plane block, comprising ropivacaine and methylene blue, wherein: the concentration of the ropivacaine is 0.5%-1.0%; the concentration of the methylene blue is 0.5%-2.0%; and the drug is used for anterior serratus plane block after prosthetic breast augmentation.

[0009] Further preferably, the concentration of the ropivacaine is 0.75%, and the concentration of the methylene blue is 1%; the drug is loaded into a light-proof syringe, the light-proof syringe is movably connected to a stable frame, and the stable frame comprises a clamping seat, a clamping seat and an opening.

[0010] Further preferably, the volume ratio of ropivacaine to methylene blue in the drug is 5:1 to 10:1.

[0011] Further preferably, the volume ratio of ropivacaine to methylene blue in the drug is 10:2.

[0012] A method for anterior serratus plane block for analgesia after prosthetic breast augmentation, comprising the following steps:

[0013] Before the surgical incision is sutured, the analgesic drug of any one of the above is injected into the anterior serratus plane of the patient;

[0014] The injection site is the 2nd, 3rd, 4th and 5th intercostal space of the anterior axillary line, and 1.0-2.0 mL of the drug is injected at each injection site.

[0015] Further preferably, the injection is performed under direct vision, and 1.5 mL of the drug is injected at each injection site.

[0016] A multi-modal analgesic system for prosthetic breast augmentation, comprising:

[0017] The analgesic drug of any one of the above is used for anterior serratus plane block;

[0018] Patient-controlled intravenous analgesia device for continuous infusion of sufentanil and ondansetron after operation;

[0019] The anterior serratus plane block is used in combination with patient-controlled intravenous analgesia.

[0020] Further preferably, the infusion rate of the patient-controlled intravenous analgesia device is 2.0 mL / h, and the duration is 48 hours.

[0021] Use of methylene blue in the preparation of a drug for prolonging the analgesic time of ropivacaine in anterior serratus plane block, the drug being used for postoperative analgesia after breast augmentation with prosthesis, and the concentration of methylene blue being 0.5%-2.0%.

[0022] Further preferably, the concentration of methylene blue is 1%.

[0023] The beneficial effects produced by the above technical solution are as follows: in the present application, 72 female patients are included in a double-blind, single-center randomized controlled trial, and they are randomly divided into a control group, a ropivacaine group and a ropivacaine+methylene blue group during operation. All the patients receive a standard postoperative analgesia scheme. Two trained independent researchers assess the pain score by using the visual analogue scale (VAS), and the observation and recording are performed at 6, 24, 48 and 72 hours after the operation. The results show that, compared with the use of ropivacaine alone, the use of methylene blue in combination with ropivacaine in anterior serratus plane block can effectively relieve acute pain during hospitalization after breast augmentation with prosthesis, provide stable analgesic effect within 72 hours after the operation, help to achieve long-acting analgesia, and has the advantage of low cost. The addition of methylene blue does not increase the incidence of adverse reactions, and has good safety and wide application potential. BRIEF DESCRIPTION OF DRAWINGS

[0024] Figure 1 It is a black light-proof syringe, and the color of the injected liquid cannot be observed from the outside.

[0025] Figure 2 It is a block site dressing that completely covers the block area to avoid the influence of methylene blue observation on the blind method.

[0026] Figure 3 It is a screenshot of a video process of anterior serratus plane block injection demonstration.

[0027] Figure 4 It is an anatomic diagram of target nerves and a schematic diagram of anterior serratus plane block (left) anatomic diagram of target nerves, white arrow shows thoracic nerve; (middle) schematic diagram of anterior serratus plane block under direct vision in the control group, the ropivacaine group and the ropivacaine+methylene blue group in breast augmentation with prosthesis, black dotted line and simulated intercostal space schematic diagram show the body surface anatomic markers of midaxillary line and each intercostal space, and red "X" marker shows the block injection area; (right) actual operation diagram of anterior serratus plane block in breast augmentation.

[0028] Figure 5 Schematic diagram of anterior serratus plane block.

[0029] Figure 6 Flow chart of random control trial enrollment and grouping.

[0030] Figure 7 VAS score after breast augmentation and intergroup comparison (*P<0.05; **P<0.01; ***P<0.001; ****P<0.0001) (upper) VAS score after breast augmentation at four time points; (lower) comparison of VAS scores in three groups (lower left 1) 6 hours after breast augmentation; (lower left 2) 24 hours after breast augmentation; (lower right 2) 48 hours after breast augmentation; (lower right 1) 72 hours after breast augmentation.

[0031] Figure 8 Side chest wall conditions 3 days and 1 month after injection of methylene blue / ropivacaine mixture, 1 month after operation, methylene blue color is not visible, no pigment deposition / tattoo-like change (upper left) patient A 3 days after operation; (upper right) patient A 1 month after operation; (lower left) patient B 3 days after operation; (lower right) patient B 1 month after operation.

[0032] Figure 9 Structure schematic diagram of light-proof syringe and stable frame of the present application;

[0033] Figure 10 Structure schematic diagram of card seat and opening of the present application;

[0034] Figure 11 Structure schematic diagram of card seat, card seat and opening of the present application.

[0035] 1-light-proof syringe, 2-stable frame, 201-card seat, 202-card seat, 203-opening. DETAILED DESCRIPTION

[0036] The following examples illustrate the present application in detail. The various raw materials and equipment used in the present application are all conventional commercially available products, which can be directly obtained by market purchase. The experimental methods used in the following examples are conventional methods unless otherwise specified.

[0037] It should be understood that when used in the specification and the appended claims of the present application, the term "comprising" indicates the presence of the described features, integers, steps, operations, elements, and / or components, but does not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and / or groups thereof.

[0038] It should also be understood that the term "and / or" as used herein refers to and encompasses any and all possible combinations of one or more of the associated listed items, and that the term "at least one of' as used herein means "one, two, three, four, or more" but not limited to "one, two, three, four, or more."

[0039] Reference throughout this application to "one embodiment" or "some embodiments" means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment of the application. Thus, the appearances of the phrases "in one embodiment," "in some embodiments," "in other embodiments," "in additional embodiments," and the like, in various places throughout this specification are not necessarily all referring to the same embodiment, unless otherwise indicated. The terms "including," "containing," "comprising," and similar terms are meant to be open-ended, unless otherwise noted, so that other components besides those listed can be included.

[0040] In addition, the terms "first," "second," "third," etc. as used in the description and the appended claims are used for distinguishing between similar elements and not necessarily for describing a sequential or chronological order. It is to be understood that the terms so used are interchangeable under appropriate circumstances such that the embodiments of the application described herein are, for example, capable of use in either order.

[0041] The specific embodiments of the present application will now be described in detail with specific reference being made to the figures. It is to be understood that the following examples are merely descriptive and are not intended to limit the scope of the application. Based on the embodiments of the present application, all other embodiments obtained by those skilled in the art without creative efforts are within the scope of the present application.

[0042] Example 1, Patients and Methods

[0043] 1.1 Ethical review

[0044] This double-blind, single-center randomized controlled trial was approved by the Medical Ethics Committee of the Chinese Academy of Medical Sciences Institute of Plastic Surgery. In addition, the study was registered in the Chinese Clinical Trial Registry (ChiCTR) in accordance with the principles of the Declaration of Helsinki, with registration number ChiCTR2500097610. Written informed consent was obtained from the patient for participation in randomization before the operation.

[0045] 1.2 Study design and participants

[0046] The study included patients who underwent breast augmentation surgery with implants at the Department of Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, between March and November 2023. Inclusion criteria: (1) age 18-70 years; (2) planned breast augmentation surgery with implants; (3) American Society of Anesthesiologists (ASA) class I-II, able to tolerate general anesthesia; (4) fully understand the condition and willing to participate; (5) normal mental status. Exclusion criteria: (1) signs of infection at the injection site; (2) history of allergy to local anesthetics, morphine, or methylene blue; (3) injection that may endanger the implant; (4) coagulation disorders; (5) chronic pain syndrome; (6) patient or their family member refuses to sign the informed consent form.

[0047] After enrollment, all patients were randomly assigned to three groups using a computer-generated randomization method: a control group, a ropivacaine group, and a ropivacaine + methylene blue group. Patients, surgeons, anesthesiologists, and the ward nursing team were unaware of the group assignments. Operating room nurses pre-prepared the blocking solution, loaded it into a light-proof black syringe, purged air bubbles from the needle tip, and placed it on a sterile operating table for later use. Figure 1 (The color of the injected fluid cannot be observed externally). Simultaneously, the injection site should be immediately covered with a sterile dressing after regional blockade to prevent the patient or surgeon from inferring treatment grouping based on spilled methylene blue. Figure 2 (The area of ​​blockade is shown to be covered by a dressing). Regional blockade is performed by a trained anesthesiologist. Figure 3 (This is a screenshot from a video demonstrating the serratus muscle plane block injection procedure before breast augmentation surgery.)

[0048] 1.3 Anesthesia and Analgesia

[0049] The selection of general anesthetic drugs followed standard procedures, and airway management was performed via endotracheal intubation during the operation. The blocking drug was loaded into a light-proof syringe before the start of surgery. Before suturing the surgical incision, the anesthesiologist entered the operating room, and the patient was placed in a supine position with arms abducted. An anterior serratus anterior muscle block was performed: the 2nd, 3rd, 4th, and 5th intercostal spaces along the anterior axillary line were located, and the drug was injected under direct vision. Figure 4 In the control group, 1.5 ml of 0.9% saline was used at each injection site; in the ropivacaine group, 1.5 ml of 0.75% ropivacaine was used at each injection site; and in the ropivacaine + methylene blue group, 1.5 ml of a mixture of 0.75% ropivacaine and 1% methylene blue (10 ml 0.75% ropivacaine + 2 ml 1% methylene blue solution) was used at each injection site. Peripheral intravenous access was established in all patients postoperatively, and patient-controlled intravenous analgesia was administered. The analgesic solution contained ondansetron 0.15 mg / kg and sufentanil 2 μg / kg, diluted to 100 ml with 0.9% saline. This technique targets the intercostal nerves in the breast region to ensure effective analgesia, and the injection site is far from important thoracic structures, significantly improving safety. Figure 5). The patient-controlled intravenous analgesia infusion rate was 2.0 ml / h, and the analgesia duration was 48 hours. No oral analgesics were given during the postoperative period.

[0050] 1.4 Primary and secondary outcome measures

[0051] The primary outcome measure was the patient-reported postoperative pain score. Secondary outcome measures included the incidence of anesthesia-related adverse reactions and complications.

[0052] Patient pain was observed and recorded independently by two trained researchers. The visual analog scale (VAS) was used to assess pain at 6 hours (T1), 24 hours (T2), 48 hours (T3), and 72 hours (T4) after surgery.27A score of 0 indicated no pain; 1-3 indicated mild pain; 4-6 indicated moderate pain; 7-9 indicated severe pain; and 10 indicated intense pain. The researchers were blinded to the patient grouping.

[0053] The researchers recorded patient postoperative analgesia-related adverse reactions, such as nausea, vomiting, diarrhea, etc.

[0054] 1.5 Statistical analysis

[0055] Statistical analysis of patient data was as follows: continuous variables were described using mean ± standard deviation (SD), and categorical variables were described using frequency and percentage. Fisher's exact probability method and chi-square test were used for categorical variables; if continuous variables met the normal distribution, one-way analysis of variance (ANOVA) was used, otherwise non-parametric test was used. All analyses were considered statistically significant at a two-sided P < 0.05. Data were analyzed using the SPSS AU data analysis platform (https: / / SPSSAU.com / ).

[0056] Example 2, Results

[0057] 2.1 Study population

[0058] A total of 72 patients agreed to participate and were included in the study, and were randomly divided into a control group, a ropivacaine group, and a ropivacaine + methylene blue group, with 24 people in each group. Two patients were lost to follow-up and were excluded from the study, and finally 70 patients were included in the analysis ( Figure 6 ). Table 1 lists the routine and comparable clinical characteristics, including prosthesis size, surgical information, and ASA classification. The average ages of the three groups of patients were similar (32.04 ± 6.83 years vs. 29.57 ± 3.15 years vs. 30.92 ± 2.99 years, P = 0.200); there was no significant difference in average BMI (19.40 ± 1.11 kg / m 2 vs. 18.70 ± 2.06 kg / m 2 vs. 18.63 ± 1.48 kg / m 2ASA classification(P=0.892), prosthesis brand(P=0.764), size(P=0.580) and type(P=0.260) were similar among the three groups.

[0059] Table 1 Baseline and clinical characteristics

[0060]

[0061]

[0062] Data are represented as mean±SD, n(%) or median(p25-p75); BMI: Body Mass Index;

[0063] ASA: American Society of Anesthesiologists.

[0064] 2.2 Postoperative VAS scores

[0065] Postoperative VAS scores at different time points in the three groups are shown in Table 2 and Figure 7 With the passage of time, VAS scores in the control group and the ropivacaine+ methylene blue group decreased significantly (T1 >T2 >T3 >T4), indicating that the changes in VAS scores at different stages were related to time. However, the VAS score in the ropivacaine group at T4 was slightly higher than that at T3, which might be related to the failure of ropivacaine action.

[0066] Table 2 Postoperative VAS scores at four time points

[0067]

[0068] Note: Data are represented as mean±SD

[0069] VAS scores were significantly lower in the ropivacaine group than in the control group at all time points except T4 (4.30 ± 1.36 vs. 3.26 ± 2.30, P = 0.119), indicating that the TSP block enhanced the early pain management effect of patient-controlled intravenous analgesia after augmentation mammoplasty. In addition, the analgesic effect was significantly better in the ropivacaine + methylene blue group than in the ropivacaine group: there was no statistically significant difference between the two groups at 6 hours after surgery (3.40 ± 2.96 vs. 2.67 ± 1.88, P = 0.857), but there were statistically significant differences at 24 hours (3.39 ± 1.95 vs. 2.08 ± 1.47, P = 0.020), 48 hours (2.78 ± 2.00 vs. 1.54 ± 1.41, P = 0.028), and 72 hours (3.26 ± 2.30 vs. 1.42 ± 1.50, P = 0.002) after surgery. Thus, ropivacaine + methylene blue had a clear advantage in long-term analgesia during hospitalization, and the addition of methylene blue did not affect the blocking effect of ropivacaine.

[0070] 2.3 Adverse reactions and complications related to analgesia

[0071] Table 3 shows that there were no differences in adverse reactions and complications related to analgesia among the three groups. Specifically, there were no differences in abdominal distension, fatigue, cough, dyspnea, anxiety, depression, or urinary retention among the three groups. At the same time, additional regional analgesia reduced the incidence of dizziness (P = 0.012), nausea (P = 0.006), vomiting (P = 0.006), and insomnia (P = 0.001). There were no statistically significant differences in adverse reactions related to analgesia between the ropivacaine group and the ropivacaine + methylene blue group. In addition, no anesthesia-related complications were reported in this study. Methylene blue was completely metabolized within 1 month after surgery, and there were no visible marks on the skin or surrounding tissues (see Figure 8 , showing the lateral chest wall 3 days and 1 month after injection of the methylene blue / ropivacaine mixture). These results indicate that TSP block combined with ropivacaine + methylene blue does not increase the incidence of adverse reactions related to analgesia (ARAE) and is a safe analgesic method.

[0072] Table 3. Adverse reactions and complications related to analgesia.

[0073]

[0074]

[0075] Note: Data are presented as n (%)

[0076] 2.4 Discussion

[0077] Pain control is essential after augmentation mammoplasty, but oral medications or patient-controlled intravenous analgesia are sometimes ineffective, and regional analgesia is increasingly used. This study is the first prospective, double-blind, randomized trial to evaluate the analgesic efficacy of a ropivacaine-methylene blue mixture in the transversus abdominis plane block in addition to patient-controlled intravenous analgesia compared with ropivacaine alone during hospitalization after prosthetic augmentation mammoplasty. The study found that the transversus abdominis plane block with a ropivacaine + methylene blue mixture was effective in controlling long-term pain for up to 72 hours after surgery compared with ropivacaine alone, which has positive implications for reducing pain and improving patient comfort and satisfaction.

[0078] The transversus abdominis plane block is a feasible alternative to multimodal analgesia after augmentation mammoplasty and has been used for acute postoperative pain control, with analgesic efficacy comparable to that of paravertebral block, which was applied earlier. The procedure is relatively simple, safe, and has a low incidence of side effects. Compared with enhanced recovery after surgery (ERAS) anesthesia protocols, it does not require complex management in the operating room, postanesthesia care unit, or ward and is expected to be one of the ERAS protocols that effectively supplement complex postoperative analgesia.

[0079] Regional blocks commonly use local anesthetics, but these drugs have disadvantages, such as short half-lives. Researchers have used various techniques to extend the duration of a single regional block. One research direction is to modify the chemical structure of local anesthetics to extend their duration of action. For example, liposomal bupivacaine can further extend the duration of local anesthesia, but the high cost limits its widespread use. Another method is “cocktail” analgesia, which uses an adjuvant that has no direct analgesic effect to assist and enhance the effects of local anesthetics. In clinical practice, the addition of an adjuvant has been shown to help extend the duration of ropivacaine. However, research on the addition of another long-acting analgesic to local anesthetics has not been fully developed. Methylene blue has the advantages of safety, low cost, and easy availability. For example, in China, the cost of a single combined block is approximately 5 US dollars, while the cost of liposomal bupivacaine is approximately 70 US dollars. In addition, the preparation of the mixture only requires the proportional mixing of the two solutions. The combination of methylene blue and ropivacaine is expected to combine the advantages of both: first, methylene blue has a certain latency before onset and may have a burning sensation before onset, while the strong short-term analgesic effect of ropivacaine can effectively suppress this discomfort; second, methylene blue is metabolized slowly in areas with few blood vessels, allowing it to continue to exert an analgesic effect after the ropivacaine wears off, and its anti-inflammatory and vasoconstrictive effects further enhance this effect. This study confirmed that the mixture provided stable analgesic effects for up to 72 hours after surgery, indicating that methylene blue may help achieve long-acting analgesia.

[0080] This study found that the combination of methylene blue and ropivacaine significantly prolonged the duration of analgesia and enhanced the analgesic effect in a model of post-prosthetic augmentation mammoplasty pain.

[0081] Example 3, Conclusion

[0082] Compared with the use of ropivacaine alone, the use of methylene blue combined with ropivacaine in the transversus abdominis plane block can effectively relieve acute pain during hospitalization after breast augmentation with prosthesis. In addition, the addition of methylene blue does not increase the incidence of adverse reactions, has good safety, and has potential for wide application. Future research designs will provide high-quality evidence for the inclusion of these analgesic regimens in the standard pain management protocol for breast augmentation with prosthesis.

[0083] Example 4

[0084] As shown in Figure 3 , Figure 4 , Figure 9 , Figure 10 , Figure 11 , the anesthesiologist needs to press the muscle towards the rib end with one hand to position the injection site when performing the transversus abdominis block anesthesia, then the needle of the light-protective syringe 1 is pierced through the skin, in order to ensure safety, the syringe needs to be withdrawn to check whether there is blood backflow when injecting the drug, if there is blood backflow, it means that the needle has pierced into the blood vessel, the position of the needle needs to be adjusted to avoid injecting the drug into the blood vessel; if there is no blood backflow, it means that the needle is not in the blood vessel, the drug is injected to infiltrate the surrounding nerves for anesthesia; however, when the existing syringe is withdrawn to check whether there is blood backflow, the anesthesiologist needs to hold the syringe barrel with one hand and the piston rod can be withdrawn with the other hand, but when the anesthesiologist holds the syringe with one hand, the pressed muscle will return to the initial state, and the muscle in the initial state is easy to cause the syringe needle to shift, resulting in unsatisfactory anesthesia effect. The stabilizing frame 2 includes a clamping seat 201, a clamping seat 202 and an opening 203, the stabilizing frame 2 is integrally formed, the stabilizing frame 2 can be made of medical plastic, the stabilizing frame 2 can also be made of metal, the length of the opening 203 is less than the diameter of the syringe barrel, before performing the block anesthesia, the anesthesiologist first clamps the stabilizing frame 2 into the light-protective syringe 1 through the opening 203, so that the clamping seat 201 connects the syringe barrel of the light-protective syringe 1, and the bottom surface of the clamping seat 202 abuts against the side wing of the syringe barrel, so that the stabilizing frame 2 connects the light-protective syringe 1, in use, the anesthesiologist pierces the needle of the light-protective syringe 1 into the skin along the positioning position of the left hand to reach the block position, adjusts the position of the right hand to make the index finger and the middle finger clamp the syringe barrel, and makes the index finger and the middle finger be located between the clamping seat 202 and the side wing of the syringe barrel, the thumb, the ring finger and the little finger are located outside the stabilizing frame 2, the index finger and the middle finger abut against the upper surface of the clamping seat, and at the same time the thumb and / or the ring finger apply force to the piston rod of the syringe, so that the piston rod is withdrawn to check whether there is blood backflow, in order to determine the position of the needle, this arrangement avoids the muscle returning to cause the needle position to shift, and improves the success rate of the anesthesia effect, when the drug is injected, the index finger and the middle finger abut against the side wing of the syringe barrel, and the thumb applies force to the piston rod to make the drug be injected around the nerves.

[0085] Although the embodiments of the present application have been shown and described, it is to be understood that various modifications, substitutions, changes and alterations can be made to these embodiments without departing from the principles and spirit of the present application, and the scope of the present application is defined by the appended claims and their equivalents.

[0086] In the above embodiments, the description of each embodiment is focused on, and the part not described or recorded in a certain embodiment can be referred to the relevant description of other embodiments.

[0087] The above-described embodiments are only used to illustrate the technical solutions of the present application, rather than limit it; although the present application has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that the technical solutions recorded in the foregoing embodiments can still be modified, or some technical features can be replaced by equivalents; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application, and should be included in the protection scope of the present application.

Claims

1. A long-acting analgesic for serratus anterior plane blockade, characterized in that, The drug comprises ropivacaine and methylene blue, wherein: the concentration of ropivacaine is 0.5%-1.0%; the concentration of methylene blue is 0.5%-2.0%; the drug is used for serratus anterior plane block after breast augmentation.

2. The analgesic drug according to claim 1, characterized in that, The concentration of ropivacaine is 0.75%, and the concentration of methylene blue is 1%. The drug is loaded into a light-proof syringe (1), and the light-proof syringe (1) is movably connected to a stabilizing frame (2). The stabilizing frame (2) includes a retainer (201), a retainer (202), and an opening (203).

3. The analgesic drug according to claim 1 or 2, characterized in that, The volume ratio of ropivacaine to methylene blue in the drug is 5:1 to 10:

1.

4. The analgesic drug according to claim 3, characterized in that, The volume ratio of ropivacaine to methylene blue in the drug is 10:

2.

5. A method for serratus anterior plane block for postoperative analgesia after breast augmentation, characterized in that, Includes the following steps: Before suturing the surgical incision, the analgesic drug according to any one of claims 1-4 is injected into the serratus anterior muscle plane of the patient; The injection sites are the 2nd, 3rd, 4th and 5th intercostal spaces along the anterior axillary line, with 1.0-2.0 mL of the drug injected at each site.

6. The method according to claim 5, characterized in that, The injections are performed under direct vision, with 1.5 mL of the drug injected at each injection site.

7. A multimodal analgesia system for breast augmentation surgery, characterized in that, include: The analgesic drug according to any one of claims 1-4 is used for serratus anterior plane block; Patient-controlled intravenous analgesia device for continuous postoperative infusion of sufentanil and ondansetron; The serratus anterior plane block is used in combination with patient-controlled intravenous analgesia.

8. The system according to claim 7, characterized in that, The patient-controlled intravenous analgesia device has an infusion rate of 2.0 mL / h and a duration of 48 hours.

9. The use of methylene blue in the preparation of drugs for prolonging the analgesic time of ropivacaine anterior serratus muscle block, characterized in that, The drug is used for postoperative analgesia after breast augmentation, and the concentration of methylene blue is 0.5%-2.0%.

10. The application according to claim 9, characterized in that, The concentration of the methylene blue is 1%.

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