依托咪酯持续输注对乳腺癌根治术患者血流动力学及炎症介质的影响

Analgesic Effect of Etomidate Infusion for Radical Mastectomy in Breast Cancer and Its Effect on Hemodynamics and Inflammatory Mediators

目的:研究依托咪酯持续输注用于乳腺癌根治术患者的镇痛效果及对血流动力学与炎症介质的影响。方法:选取2015年8月至2016年7月我院收治的84例乳腺癌根治术患者,根据患者入院顺序分为观察组和对照组,42例每组。观察组持续输注依托咪酯,对照组持续输注丙泊酚。比较两组患者手术后不同时点视觉模拟评分(VAS),拔管时舒张压(DBP)、收缩压(SBP)、心率(HR)及血清白介素-2(IL-2)、IL-10、IL-12水平的变化。结果:拔管时,观察组的DBP、SBP、HR水平显著低于对照组(P<0.05)。观察组在术后1、5、10、24、48 h的VAS评分均显著低于对照组(P<0.05)。观察组术后3天时血清IL-2水平显著高于对照组(P<0.05),IL-10、IL-12水平显著低于对照组(P<0.05)。结论:依托咪酯持续输注用于乳腺癌根治术患者中的镇痛效果良好,且对患者血流动力学与炎症反应的影响较小。

Objective：To study the analgesic effect of etomidate infusion for radical mastectomy in breast cancer and its effect on hemodynamics and inflammatory mediators.Methods：From August 2015 to July 2016,84 patients with radical mastectomy were divided into the observation group and the control group according to the order of admission.The observation group was given continued infusion of etomidate,the control group was given continued infusion of propofol.The visual analogue（VAS） at different time points after operation,diastolic blood pressure（DBP）,systolic blood pressure（SBP） and heart rate（HR） at the time of extubation and serum IL-2,IL-10,IL-12 levels at 72 hours after operation were compared between two groups.Results：At the time of extubation,the DBP,SBP and HR were significantly lower in the observation group than in the control group（P0.05）.The VAS scores of observation group were significantly lower than those of the control group at 1,5,10,24 and 48 hours after operation（P 0.05）.The serum levels of IL-2 in the observation group was significantly higher than that of the control group（P0.05）,IL-10 and IL-12 levels were lower than control group（P0.05）.Conclusion：Sustained infusion of etomidate had good analgesic effect in the treatment of breast cancer patients underwent radical mastectomy with little effect on the hemodynamics and inflammatory mediators.