静脉麻醉联合局部麻醉在乳腺肿物真空辅助微创旋切术中的应用

Application of intravenous anesthesia combined with local anesthesia in vacuum assisted minimally invasive rotary varicotomy of breast masses

目的分析总结布托啡诺+丙泊酚静脉麻醉联合利多卡因局部浸润麻醉在乳腺肿物真空辅助微创旋切术的临床应用体会。方法将2015年7月～2018年1月在我院住院治疗的160例乳腺肿物行真空辅助麦默通微创旋切术的患者,按麻醉方式分为试验组(静脉麻醉联合局部浸润麻醉)和对照组(局部浸润麻醉),每组各80例,比较并分析两组的麻醉效果,术前、术中和术后血氧饱和度(SpO_2),两组术中血压(BP)和心率(HR),不良反应发生率及患者对手术的满意度和耐受度等。结果两组麻醉成功率均为100.00%,试验组术前、术中、术后SpO_2与对照组比较,差异无统计学意义(P> 0.05),试验组术中的血压、心率情况与对照组比较,差异有统计学意义(P <0.01)。试验组不良反应率明显低于对照组,差异有统计学意义(P <0.05)。试验组的满意度以及耐受度与对照组相比,差异均有统计学意义(P <0.05)。结论在乳腺肿物真空辅助微创旋切术中采取布托啡诺+丙泊酚静脉麻醉联合利多卡因局部浸润麻醉,麻醉效果显著,值得临床推广。

Objective To analyze and summarize the clinical experience of butorphanol and propofol intravenous anesthesia combined with lidocaine local infiltration anesthesia in vacuum assisted minimally invasive rotary varicotomy of breast masses.Methods One hundred and sixty hospitalized patients who underwent vacuum assisted Mammotome minimally invasive rotary varicotomy of breast masses from July 2015 to January 2018 were selected.They were divided into the experimental group(intravenous anesthesia combined with local infiltration anesthesia)and the control group(local infiltration anesthesia)according to different anesthesia method,with 80 cases in each group.The anesthetic effect,preoperati ve,intraoperative and postoperative oxygen saturation(SpO2),intraoperative blood pressure(BP)and heart rate(HR),incidence of adverse reactions and patients'satisfaction with and tolerance to surgery were compared and analyzed between the two groups.Results The success rate of anesthesia in two groups was both 100%.Difference in the preoperative,intraoperative and postoperative SpO2 in the experimental group and the control group had no statistical significance(P>0.05).Difference in intraoperative blood pressure and heart rate in the experimental group and the control group was statistically significant(P<0.01).The incidence of adverse reactions in the experimental group was significantly lower than that in the control group.The difference was statistically significant(P<0.05).Satisfaction and tolerance in the experimental group and the control group were significantly different and the difference was statistically significant(P<0.05).Conclusion Butorphanol and propofol intravenous anesthesia combined with lidocaine local infiltration anesthesia in vacuum assisted minimally invasive rotary varicotomy of breast masses has significant anesthetic effect,which is worthy of clinical promotion and application.