靶控瑞芬太尼辅助乳腺癌手术硬膜外麻醉的临床分析

Clinical analysis of remifentanil target controlled infusion applied in epidural anesthesia of mastectomy

目的探讨瑞芬太尼血浆靶控输注(TCI)应用于乳腺癌手术硬膜外麻醉的辅助意义。方法 86例择期行乳腺癌手术患者随机分为观察组与对照组,各43例。观察组采用瑞芬太尼TCI联合硬膜外麻醉,对照组单纯应用硬膜外麻醉,比较两组的麻醉效果。结果观察组术中血流动力学指标波动幅度低于对照组(P<0.05);观察组的镇静优良率为95.35%,优于对照组的76.74%(P<0.05);观察组的术后睁眼时间以及恢复自主呼吸时间均较对照组明显缩短(P<0.05)。结论瑞芬太尼TCI辅助乳腺癌手术硬膜外麻醉可维持血流动力学稳定,提高麻醉镇痛质量,改善术后苏醒质量,提高麻醉及手术安全性。

Objective To investigate the secondary meaning of remifentanil target controlled infusion （TCI） applied in epidural anesthesia of mastectomy. Methods 86 mastocarcinoma patients who have had mastectomy were randomly divided into observation group and control group, 43 cases in each. The observation group received remifentanil TCI combined with epidural anesthesia, and the control group received epidural anesthesia alone. Then the anesthetic effect were compared. Results The volatility of intraoperative hemodynamic fluctuations in observation group was significantly lower than the control group （P 〈 0.05 ） ; the sedation excellent rate of observation group was 97.67%, significantly higher than 81.40% in the control group （P 〈 0.05 ） ; the eye opening time and recovery time of spontaneous breathing in observation postoperative was significantly shorter than the control group （P 〈 0.05）. Conclusion Remifentanil TCI applied in epidural anesthesia of mastectomy can maintain hemodynamic stability, improve the quality of analgesia, the quality of postoperative recovery and the safety of anesthesia in surgery.