依托咪酯静脉维持麻醉对乳腺癌手术患者术后苏醒质量的影响

Effects of intravenous anesthesia maintained by etomidate on recovery quality in breast cancer patients undergoing radical mastectomy

目的观察依托咪酯用于乳腺癌手术患者的静脉麻醉维持对患者术后苏醒质量的影响。方法将60例拟在全身麻醉下进行乳腺癌根治术的患者随机分为试验组30例和对照组30例。试验组术中麻醉维持为持续静脉输注依托咪酯10~15μg·kg^(-1)·min^(-1);对照组术中持续输注丙泊酚6~8 mg·kg^(-1)·h^(-1)。记录2组患者睁眼时间、拔管时间、定向力恢复时间,观察患者拔管期血流动力学变化及恶心呕吐、体动等不良反应发生情况。结果试验组和对照组患者停药后睁眼时间和拔管时间差异均无统计学意义(P>0.05);试验组拔管期血流动力学稳定,与对照组比较差异无统计学意义(P>0.05)。试验组恶心、呕吐发生率显著高于对照组(P<0.05)。结论依托咪酯联合瑞芬太尼持续输注用于乳腺癌手术的静脉麻醉维持,不延长患者拔管时间,拔管期血流动力学稳定,苏醒质量满意,对短小手术的静脉维持麻醉是安全的。

Objective To evaluate the effects of etomidate used for maintenance of intravenous anesthesia on recovery quality in breast cancer patients undergoing radical mastectomy. Methods Sixty breast cancer patients scheduled to receive radical mastectomy were randomly divi-ded into treatment group and control group,30 patients in each group. Anesthesia was maintained by continuous infusion of etomidate10-15 μg·kg^-1·min^-1n treatment group, or propofol 6-8mg·kg^-1·h^-1n control group. In two groups,open eyes time,extubation time and orientation recovery time were observed. The hemodynamics indexes during extubation period and adverse drug reactions such as nausea,vomiting were also recorded. Results There were no statistical differences about open eyes time and extubation time in all patients of the two groups（P〉0. 05）. During extubation period of anesthesia,treatment group could keep relatively stable hemodynamics,but the differences had no statistically significant between two groups. In treatment group,the incidence of nausea and vomiting was significantly higher than that of control group（P〈0. 05）. Conclusion In radical mastectomy of breast cancer patients,application of etomidate combined with remifentanil for anesthesia maintenance has shorter extubation time,hemodynamic stability and satisfactory recovery quality from intravenousanesthesia. It proves that intravenous anesthesia maintained by etomidate in short-time surgery is safe and feasible.