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[肋间神经阻滞联合七氟醚吸入麻醉喉罩通气对乳腺癌改良根治术患者应激反应的影响]

[Effects of combined intercostal nerves block-sevoflurane used inhalation anesthesia with laryngeal mask ventilation on the stress response in patients suffered from breast neoplasms undergoing modified radical mastectomy].

作者信息

Lin Zheng, Han Xiao-dong, Liu Zhong-di, Wang Jin-long

机构信息

Department of Anesthesiology, Second People's Hospital of Wenzhou, Wenzhou 325000, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2009 Jun 16;89(23):1617-9.

Abstract

OBJECTIVE

To investigate the influence of combined intercostal nerves block-sevoflurane used inhalation anesthesia with laryngeal mask ventilation on the stress response to modified radical mastectomy.

METHODS

60 patients with ASA physical status I-II, aged 33-53 years and scheduled for modified radical mastectomy were randomly divided into group I and group II. 30 cases each group. Patients in both groups received modified radical mastectomy under sevoflurane used inhalation anesthesia with laryngeal mask ventilation, and group II received intercostal nerves block before anesthesia induction. Blood samples were taken before anesthesia,at incision, one hour after incision and 5 minutes after the end of surgery for determination of serum concentration of cortisol and angiotension. Blood pressure and heart rate of patients was also recorded during the operation.

RESULTS

Compared with the baseline value before anesthesia, serum cortisol and angiotension increased 5 minutes after the end of surgery in both groups, but the concentration in group I were higher than that in group II. At incision the concentration of cortisol in group I were higher than the baseline value and the same time in group II.

CONCLUSION

Combined intercostal nerves block-sevoflurane used inhalation anesthesia with laryngeal mask ventilation can reduce the stress response in patients undergoing modified radical mastectomy.

摘要

目的

探讨肋间神经阻滞联合七氟醚吸入麻醉喉罩通气对改良根治性乳房切除术应激反应的影响。

方法

将60例ASA身体状况I-II级、年龄33-53岁、计划行改良根治性乳房切除术的患者随机分为I组和II组,每组30例。两组患者均在七氟醚吸入麻醉喉罩通气下行改良根治性乳房切除术,II组在麻醉诱导前接受肋间神经阻滞。于麻醉前、切皮时、切皮后1小时及手术结束后5分钟采集血样,测定血清皮质醇和血管紧张素浓度。术中记录患者血压和心率。

结果

与麻醉前基线值相比,两组患者手术结束后5分钟血清皮质醇和血管紧张素均升高,但I组浓度高于II组。切皮时I组皮质醇浓度高于基线值及同期II组。

结论

肋间神经阻滞联合七氟醚吸入麻醉喉罩通气可减轻改良根治性乳房切除术患者的应激反应。

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