Das Rekha, Das Rajat Kumar, Sahoo Sushrita, Nanda Suchismita
Department of Anaesthesiology, AHRCC, Cuttack, Odisha, India.
Department of Anaesthesiology SCB Medical College, Cuttack, Odisha, India.
Indian J Anaesth. 2018 Mar;62(3):182-187. doi: 10.4103/ija.IJA_752_17.
Breast cancer surgery can be carried out as day-care procedure to increase patient turnover, decrease disease progression and financial burden. The present study was carried out to assess the role of dexmedetomidine in breast cancer surgery as a day-care procedure.
This prospective randomised, double-blind study was carried out on 100 patients screened for day-care breast cancer surgery. They were divided into two groups of 50 each; who received either normal saline (Group NS) or 0.6 μg/kg/h dexmedetomidine (Group D) infusion from 10 min before induction until skin closure. All patients were given general anaesthesia. The incidence of discharge, post-operative pain (POP), average rescue analgesia (fentanyl) required and side effects were noted. Statistical analysis was performed using Student's -test and Chi-square test.
Incidence of discharge in group NS was 60% compared to 88% in Group D ( = 0.001). Average rescue analgesia requirement by group NS was 136.07 ± 43.06 μg, whereas it was 77.5 ± 29.86 μg in Group D ( = 0.01). The incidence of POP in 6 h and within 2 h of expected discharge time in Group NS was 56% and 28%, respectively, and in Group D, it was 8% in both the periods ( < 0.001 and 0.01). Side effects such as post-operative nausea, vomiting and bleeding were encountered in eight and two patients, respectively, in Group NS and two and one patients, respectively, in Group D.
Dexmedetomidine as an anaesthetic adjuvant makes breast cancer surgery feasible on day-care basis.
乳腺癌手术可作为日间手术进行，以提高患者周转率、减少疾病进展和减轻经济负担。本研究旨在评估右美托咪定在乳腺癌日间手术中的作用。
本前瞻性随机双盲研究对100例筛选为乳腺癌日间手术的患者进行。他们被分为两组，每组50例；从诱导前10分钟至皮肤缝合，分别接受生理盐水（NS组）或0.6μg/kg/h右美托咪定（D组）输注。所有患者均接受全身麻醉。记录出院率、术后疼痛（POP）、所需平均补救镇痛（芬太尼）及副作用。采用学生t检验和卡方检验进行统计学分析。
NS组出院率为60%，而D组为88%（P = 0.001）。NS组平均补救镇痛需求量为136.07±43.06μg，而D组为77.5±29.86μg（P = 0.01）。NS组术后6小时及预期出院时间2小时内的POP发生率分别为56%和28%，而D组在这两个时间段均为8%（P < 0.001和0.01）。NS组分别有8例和2例患者出现术后恶心、呕吐和出血等副作用，D组分别有2例和1例。
右美托咪定作为麻醉辅助剂使乳腺癌日间手术成为可能。
