低浓度罗哌卡因复合芬太尼硬膜外麻醉在乳癌手术中的临床应用

The effect of epidural block on patients undergoing the operation of breast cancer

目的探讨低浓度罗哌卡因复合芬太尼硬膜外麻醉在乳癌手术中的可行性。方法选择ASA I^1I级,年龄35~65岁行择期乳腺手术的女性患者80例,按照随机数字表法分为观察组(0.2%罗哌卡因+5μl/ml芬太尼组)和对照组(0.375%罗哌卡因组)各40例。经T4~5间隙行硬膜外穿刺成功后给药(0.2%罗哌卡因+5μl/ml芬太尼或0.375%罗哌卡因)。观察硬膜外麻醉起效时间,评估麻醉效果,监测血流动力学指标及脉搏氧饱和度,测量手术前后动脉血气。结果观察组硬膜外麻醉效果满意,无呼吸、循环抑制;对照组麻醉前后血流动力学指标比较,差异有统计学意义(P<0.05)。两组间血流动力学指标及术毕时脉搏氧饱和度比较,差异有统计学意义(P<0.05)。结论 0.2%罗哌卡因复合芬太尼胸段硬膜外麻醉,镇痛效果好,对呼吸及循环无明显影响,可安全用于乳癌手术。

Objective To investigate the effect of thoracic epidural block of 0.2%ropivacaine combined fentanyl on patients undergoing the operation of breast cancer.Methods 80 patients with breast cancer were randomly divided into the observation group(received 0.2%ropivacaine plus fentanyl epidural anesthesia)and the control group(received 0.375%ropivacaine epidural anesthesia).The onset time of sensory block and effect of epidural block were accessed.Hemodynamic parameters were monitored and artery blood gas was measured.The side effects if any were recorded.Results There were no respiratory and circulatory depression in the observation group.The onset time of sensory block and effect of anesthesia were similar between the two groups(P>0.05).There were significant differences on hemodynamic parameters and oxygen saturation between the two groups.Conclusion Epidural ropivacaine combined fentanyl can be used safely for radical mastectomy on patients undergoing the operation of breast cancer.