右美托咪定复合瑞芬太尼静脉麻醉对乳腺癌根治术患者血流动力学和麻醉质量的影响研究

Effect of dexmedetomidine combined with remifentanil intravenous anesthesia on hemodynamics and anesthetic quality in patients undergoing radical mastectomy

目的探究在乳腺癌根治术中应用右美托咪定复合瑞芬太尼静脉麻醉的效果,并分析其对对患者血流动力学的影响。方法回顾性分析2018年3月至2020年2月于本院接受治疗的78例乳腺癌患者作为研究对象,所有患者均行乳腺癌根治术,将采用瑞芬太尼静吸麻醉的患者作为参照组(n=35),将采用右美托咪定复合瑞芬太尼静脉麻醉的患者作为研究组(n=43)。比较两组患者不同时间段舒张压、收缩压、血氧饱和度、心率,比较两组患者自主呼吸恢复时间、睁眼时间、拔管时间。结果麻醉前,两组舒张压、收缩压、心率及血氧饱和度水平比较差异无统计学意义;插管时,研究组舒张压、收缩压及心率水平均高于参照组(P<0.05);切皮时,研究组收缩压水平低于参照组,舒张压、心率水平均高于参照组(P<0.05);切皮后,研究组舒张压、收缩压水平均低于参照组,心率水平高于参照组(P<0.05);拔管后,研究组收缩压水平低于参照组(P<0.05),两组舒张压与心率比较差异无统计学意义。研究组睁眼时间、自主呼吸恢复时间、拔管时间均短于参照组(P<0.05)。结论乳腺癌根治术患者实施右美托咪定复合瑞芬太尼静脉麻醉的麻醉质量高,且对舒张压、收缩压、心率影响较小。

Objective To explore the effect of dexmedetomidine combined with remifentanil intravenous anesthesia in radical mastectomy for breast cancer and analyze its effect on hemodynamics.Methods A total of 78 breast cancer patients treated in our hospital from March 2018 to February 2020 were retrospectively analyzed.All patients underwent radical mastectomy.Patients under remifentanil intravenous anesthesia were selected as the reference group(n=35),and patients under dexmedetomidine combined with remifentanil intravenous anesthesia were selected as the study group(n=43).The diastolic blood pressure,systolic blood pressure,blood oxygen saturation and heart rate between the two groups were compared in different time periods,and the recovery time of spontaneous breathing,eye opening time and extubation time between the two groups were compared.Results Before anesthesia,there was no significant difference in the levels of diastolic blood pressure,systolic blood pressure,heart rate and blood oxygen saturation between the two groups;at the time of intubation,the levels of diastolic blood pressure,systolic blood pressure and heart rate of the study group were higher than the reference group(P<0.05);during skin cutting,the systolic blood pressure level of the study group was lower than the reference group,and the diastolic blood pressure and heart rate level of the study group were higher than the reference group(P<0.05);after skin cutting,the diastolic blood pressure and systolic blood pressure level of the study group were lower than the reference group,and the heart rate level was higher than the reference group(P<0.05);after extubation,the systolic blood pressure level of the study group was lower than the reference group(P<0.05),there was no significant difference in diastolic blood pressure and heart rate between the two groups.Compared with the reference group,the eye opening time,spontaneous breathing recovery time and extubation time of the study group were shorter than those of the reference group(P<0.05).Conclusion The quality of anesthesia of dexmedetomidine combined with remifentanil intravenous anesthesia in patients undergoing radical mastectomy is high,and has little effect on diastolic blood pressure,systolic blood pressure and heart rate.