乳癌改良根治术三种插管全麻方法的麻醉效果比较

THE CLINICAL EFFECT OF THREE DIFFERENT METHODS OF INTUBATION ANESTHESIA FOR MODIFIED MASTECTOMY

目的研究乳腺癌改良根治术三种插管全麻方法,评选最佳方案。方法选择90例乳腺癌患者,采用随机方法分组,分为全凭吸入全麻(VCA)、硬膜外吸入复合全麻(VECA)、静脉吸入复合全麻(VI-CA),比较三组血流动力学、术后苏醒情况及拔管时间。结果 各组麻醉诱导后、切皮时平均动脉压(MAP)、心率(HR)无明显变化(p<0.05),手术结束后,VCA组MAP稍升高、HR稍增快。VECA和VICA组,血流动力学无明显变化,术后苏醒较快,拔管时间较早。静脉吸入复合全麻(VICA)组苏醒质量最佳。结论乳癌改良根治术可选择(VECA)、(VICA)麻醉。VICA更安全有效,苏醒快。

Objective This study was designed to compare three kinds of intubation anesthesia methods in modified mastectomy to select the appropriate method of anesthesia.Methods 90 patients undergoing radical mastectomy were divided into VCA,VECA and VICA groups randomly.Each has 30 cases.Observed on average artery pressure（MAP）,heart rate（HR）,analgesia quality,recovery of anesthesia and time of extubation.Results MAP and HR remained stable and no complications of anesthesia after tracheal intubation and skin incison in all patients.When the operation were over,in VCA group,MAP higher and HR increased obviously than others.VECA and VICA group showed significant less hemodynamic changes and better consciousness recovery than VCA group.The Consciousness recovery in Group VICA is the best.Conclusion VECA and VICA should be selected anesthesia for undergoing radical mastectomy,while VICA is safe and effective,recovery faster from operation.