化疗因素对乳腺癌患者异丙酚镇静效应的影响

Effect of chemotherapy on sedation with propofol in breast cancer patients

目的 评价化疗因素对乳腺癌患者异丙酚镇静效应的影响.方法 择期行乳腺癌改良根治术的女性患者100例,ASA分级Ⅰ或Ⅱ级,年龄20 ～ 60岁,根据术前是否接受新辅助化疗分为2组（n=50）：未化疗组（Ⅰ组）和新辅助化疗组（Ⅱ组）,Ⅰ组患者直接接受手术治疗,Ⅱ组患者进行新辅助化疗：第1、2天静脉注射表柔比星75 ～ 100 mg/m2,第3天静脉注射多西紫杉醇75 mg/m2,3周为1个疗程.并于第4个疗程结束后3周进行手术.麻醉诱导时靶控输注异丙酚,血浆靶浓度3.5μg/ml,记录意识消失时间和意识消失时异丙酚用量和BIS值.结果 与Ⅰ组比较,Ⅱ组意识消失时间缩短,意识消失时异丙酚用量和BIS值降低（P＜0.05）.结论 化疗因素可增强乳腺癌患者异丙酚的镇静效应,并促进其起效.

Objective To evaluate the effect of chemotherapy on sedation with propofol in breast cancer patients.Methods One hundred female patients,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,scheduled for elective modified radical mastectomy,were divided into 2 groups （n =50 each） according to whether receiving neoadjuvant chemotherapy before operation：non-chemotherapy group （group Ⅰ） and neoadjuvant chemotherapy group （group Ⅱ）.The breast cancer patients received operation directly in group Ⅰ.The breast cancer patients received neoadjuvant chemotherapy in group Ⅱ.Epirubicin 75-100 mg/m2 was injected intravenously on 1st and 2nd days,docetaxel 75 mg/m2 was injected intravenously on 3rd day,and 3 weeks were considered as 1 course of treatment.The patients received operation at 3 weeks after the end of 4 courses of treatment in group 1.Anesthesia was induced with propofol given by target-controlled infusion and the target plasma concentration of propofol was 3.5 μg/ml.The time for loss of consciousness and consumption of propofol at loss of consciousness were recorded.Results Compared with group Ⅰ,the time for loss of consciousness was significantly shortened,and the consumption of propofol at loss of consciousness and BIS value were decreased in group Ⅱ.Conclusion Chemotherapy can enhance propofol-induced sedation and promote the onset of propofol in breast cancer patients.