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舒芬太尼和丙泊酚全静脉麻醉在根治性乳房切除术中的临床价值。

Clinical Value of Total Intravenous Anesthesia with Sufentanil and Propofol in Radical Mastectomy.

机构信息

Department of Anesthesiology, Yantaishan Hospital, Yantai, 264000 Shandong, China.

Department of Radiotherapy, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013 Shandong, China.

出版信息

Dis Markers. 2022 Aug 5;2022:7294358. doi: 10.1155/2022/7294358. eCollection 2022.

Abstract

OBJECTIVE

To investigate the clinical value of sufentanil combined with propofol for total intravenous anesthesia (TIVA) in radical mastectomy.

METHODS

The data of 120 patients undergoing radical mastectomy of breast cancer in our hospital from February 2020 to February 2021 were retrospectively analyzed, and they were randomly assigned to the experimental group (EXG) ( = 60) and the control group (COG) ( = 60). The anesthesia maintenance scheme was 0.01-0.03 g/(kg·min) of sufentanil + 80-100 g/(kg·min) of propofol in EXG and 3 g/(kg·h) of fentanyl + 80-100 g/(kg·min) of propofol in COG. The hemodynamic indices, stress indexes, postoperative pain scores, and incidence of adverse reactions were compared between EXG and COG.

RESULTS

The heart rates (HR) and mean arterial pressure (MAP) after tracheal intubation (T) and at separation of deep tissues (T), tracheal extubation (T), and the end of surgery (T) were markedly lower in EXG than in COG ( < 0.001). The stress indexes and postoperative pain scores at 1 h (T), 6 h (T), and 12 h (T) after surgery were lower in EXG than in COG ( < 0.001). The incidence of dizziness, headache, pruritus, and emergence agitation in EXG was lower compared with that in COG ( < 0.05).

CONCLUSION

Sufentanil combined with propofol for TIVA can stabilize intraoperative hemodynamic indices of patients undergoing radical mastectomy, alleviate perioperative stress response, and reduce pain perception. Therefore, this anesthesia method is safe and merits clinical promotion.

摘要

目的

探讨舒芬太尼复合丙泊酚全凭静脉麻醉(TIVA)在乳腺癌根治术中的临床价值。

方法

回顾性分析 2020 年 2 月至 2021 年 2 月我院收治的 120 例行乳腺癌根治术患者的临床资料,采用随机数字表法将患者分为实验组(EXG)(n=60)和对照组(COG)(n=60)。EXG 组麻醉维持方案为舒芬太尼 0.01-0.03μg/(kg·min)+丙泊酚 80-100μg/(kg·min),COG 组麻醉维持方案为芬太尼 3μg/(kg·h)+丙泊酚 80-100μg/(kg·min)。比较 EXG 组与 COG 组患者的血流动力学指标、应激指标、术后疼痛评分及不良反应发生率。

结果

EXG 组患者气管插管即刻(T)、分离深部组织时(T)、气管拔管即刻(T)、术毕时(T)的心率(HR)和平均动脉压(MAP)均明显低于 COG 组(<0.001)。EXG 组患者术后 1 h(T)、6 h(T)、12 h(T)时的应激指标和术后疼痛评分均低于 COG 组(<0.001)。EXG 组患者头晕、头痛、瘙痒、苏醒期躁动的发生率低于 COG 组(<0.05)。

结论

舒芬太尼复合丙泊酚 TIVA 可稳定乳腺癌根治术患者术中血流动力学指标,减轻围术期应激反应,降低疼痛感知,该麻醉方法安全可靠,值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6055/9374541/b0b75e9787dd/DM2022-7294358.001.jpg

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