地佐辛联合丙泊酚麻醉在部分乳腺手术中的应用

Research of Dezocine Combined with Propofol Target-Controlled Infusion for Breast Surgery

目的研究地佐辛或芬太尼联合丙泊酚靶控输注(TCI)应用于乳腺短小手术的安全性和有效性。方法将60例ASA I^II级择期行乳腺短小手术的患者,分为两组,每组30例,每组病人分配的机率均等。D组静注地佐辛0.16 mg/kg,15 min后TCI丙泊酚,血浆靶浓度为4μg/mL;F组芬太尼1.6μg/kg静注1 min后,行丙泊酚TCI,血浆靶浓度设定为4μg/mL,直至改良清醒镇静(MOAA/S)评分为0分开始手术。记录时点T1(入室后)、T2(MOAA/S评分为0时)、T3(切皮时)、T4(术毕时)及T5(苏醒时)的MAP、HR、SPO2及各组丙泊酚的总用量,手术、苏醒、定向力恢复时间和VAS评分。结果两组手术、苏醒、定向力恢复时间、丙泊酚的总量及VAS评分没有差异。与F组比较,D组在T2、T3时点SPO2降低较少,且呼吸抑制较少发生。结论地佐辛0.16 mg/kg联合丙泊酚TCI用于乳腺短小手术是安全有效的。

Objective To explore the safety and effectiveness of Dezocine or Fentanyl combined with Propofol target - controlled infusion （TCI） for breast surgery. Methods 60 patients （ASA I -II） were divided into two groups, 30 cases in each group and the distribution of patients was with equal probability. Patients in Group D was injected with dezocine at 0. 16 mg/kg 15 minutes before TCI of Propofol and the target plasma concentration was 4 μg/mL, while patients in Group F was injected with fentanyl at i. 6 μg/kg 1 minute before TCI of Propofol and the target plasma concentration was 4 μg/mL. The operation was not implemented until the score of modified conscious sedation （MOAA/S） was 0 point. The MAP, HR and SPO2 at T1 - T5 were recorded. The total amount of Propofol, operation time, recovery time, time for orientation recovery and VAS score were recorded. Results There were no differences between the two groups in terms of operation time, recovery time, orientation recovery time, total amount of Propofol and VAS score. Compared with the Group F, there was less decrease of SPO2 and the respiratory inhibition at T2, T3 in Group D. Conclusion Dezo- cine （0. 16 mg/kg） combined with Propofol TCI for breast operation is safe and effective.