不同靶控浓度舒芬太尼复合丙泊酚用于乳腺癌手术的麻醉效果比较

Anesthetic effect of sufentanil combined with propofol in different target-controlled concentrations in patients with breast cancer

目的比较对乳腺癌手术患者实施不同靶控浓度舒芬太尼复合丙泊酚的麻醉效果,为临床提供指导.方法选取2015年1月10日至2017年12月20日慈溪市妇幼保健院收治的乳腺癌手术患者80例为观察对象,采用随机数字表法将其分为三组,其中甲组(28例,术中舒芬太尼血浆靶控浓度为0.2 ng/mL)、乙组(27例,术中舒芬太尼血浆靶控浓度为0.4 ng/mL)、丙组(24例,术中舒芬太尼血浆靶控浓度为0.8 ng/mL),三组患者丙泊酚血浆靶控浓度均为3μg/mL,研究比较三组患者的血流动力学水平[平均动脉压(MAP)、心率(HR)]、血氧饱和度(SpO2)、苏醒时间、呼吸恢复时间及不良反应发生率.结果甲组、乙组、丙组患者T2、T3、T4的MAP[T2:(78.56±7.42)mmHg比(76.98±7.65)mmHg比(69.36±7.69)mmHg;T3:(88.24±7.61)mmHg比(86.95±7.59)mmHg比(69.41±7.70)mmHg;T4:(72.32±7.51)mmHg比(69.24±7.21)mmHg比(66.52±6.85)mmHg]、HR[T2:(73.65±8.75)次/min比(73.49±8.69)次/min比(68.36±7.79)次/min;T3:(76.75±8.95)次/min比(75.58±7.96)次/min比(68.65±7.36)次/min;T4:(71.42±7.41)次/min比(70.24±6.49)次/min比(64.39±6.62)次/min]差异有统计学意义[F(MAP)值分别为8.524、15.365、5.325;F(HR)值分别为8.104、12.521、5.015],均P<0.05,但甲组、乙组、丙组患者T2、T3、T4的SpO2差异均无统计学意义(均P>0.05);甲组、乙组、丙组患者之间的苏醒时间、呼吸恢复时间差异无统计学意义(P>0.05);甲组、乙组、丙组患者之间不良反应发生率差异无统计学意义(P>0.05).结论对乳腺癌手术患者实施靶控浓度为0.8 ng/mL舒芬太尼复合3μg/mL丙泊酚的麻醉效果更佳,有助于保持患者血流动力学稳定.

Objective To explore the anesthetic effect of sufentanil combined with propofol with different target control concentration for breast cancer patients.Methods From January 10,2015 to December 20,2017,according to the digital table,80 patients with breast cancer in the Maternal and Child Health Hospital of Cixi were randomly divided into three groups:group A(28 cases,the intraoperative sufentanil plasma target control concentration was 0.2ng/mL),group B(27 cases,the intraoperative sufentanil plasma target control concentration was 0.4ng/mL),group C(24 cases,the intraoperative sufentanil plasma target control concentration was 0.8ng/mL).The plasma target control concentration of propofol in three groups was 3μg/mL.The hemodynamic level[mean arterial pressure(MAP),heart rate(HR)],blood oxygen saturation(SpO2),recovery time,respiratory recovery time and incidence of adverse reactions were compared among the three groups.Results The MAP of T2,T3 and T4 in group A,group B and group C[T2:(78.56±7.42)mmHg vs.(76.98±7.65)mmHg vs.(69.36±7.69)mmHg;T3:(88.24±7.61)mmHg vs.(86.95±7.59)mmHg vs.(69.41±7.70)mmHg;T4:(72.32±7.51)mmHg vs.(69.24±7.21)mmHg vs.(66.52±6.85)mmHg],HR[T2:(73.65±8.75)times/min vs.(73.49±8.69)times/min vs.(68.36±7.79)times/min;T3:(76.75±8.95)times/min vs.(75.58±7.96)times/min vs.(68.65±7.36)times/min;T4:(71.42±7.41)times/min vs.(70.24±6.49)times/min vs.(64.39±6.62)times/min]showed significant differences[F(MAP)=8.524,15.365,5.325;F(HR)=8.104,12.521,5.015,all P<0.05].However,there were no statistically significant differences in SpO 2 among group A,group B and group C in T2,T3 and T4(all P>0.05).There were no statistically significant differences in resuscitation time and respiratory recovery time among group A,group B and group C(all P>0.05).There was no statistically significant difference in the incidence of adverse reactions among group A,group B and group C(P>0.05).Conclusion 0.8ng/mL sufentanil combined with 3μg/mL propofol has better anesthetic effect on patients undergoing breast cancer surgery,which is helpful to maintain hemodynamic stability.