精准化麻醉策略对乳腺癌全身麻醉术患者围手术期血流动力学、认知功能及疼痛的影响

Effect of precise anesthesia strategy on perioperative hemodynamics,cognitive function and pain in breast cancer patients undergoing general anesthesia

目的分析精准化麻醉策略对乳腺癌全身麻醉术患者围手术期血流动力学、认知功能及疼痛的影响。方法选取2021年10月至2023年10月南昌市人民医院收治的80例拟行乳腺癌全身麻醉术患者作为研究对象。依据患者意愿选择麻醉方案,将患者分为对照组(42例)与精准麻醉组(38例)。对照组行常规麻醉监测方案,精准麻醉组予以精准化麻醉监测调控策略。分析两组手术期间血流动力学变化情况,比较两组患者围手术期的认知功能[简易精神状态检查量表(MMSE)]与疼痛程度[视觉模拟评分法(VAS)]。结果手术期间,精准麻醉组的血流紊乱总发生率(13.16%)低于对照组(38.10%),差异有统计学意义(P<0.05)。两组患者术后24 h(T_(1))、术后48 h(T_(2))时的MMSE量表评分均低于本组术前(T_(0))时,T_(2)时的MMSE评分均高于本组T_(1)时,差异有统计学意义(P<0.05);精准麻醉组T_(1)、T_(2)时的MMSE评分均高于对照组,差异有统计学意义(P<0.05)。两组患者T_(1)、T_(2)时的VAS评分均高于本组T_(0)时,T_(2)时的VAS评分均低于T_(1)时,差异有统计学意义(P<0.05);精准麻醉组T_(1)、T_(2)时的VAS评分均低于对照组,差异有统计学意义(P<0.05)。结论对乳腺癌全身麻醉术患者采用精准化麻醉策略,可以减少麻醉对认知功能的影响,并控制疼痛程度。

Objective To analyze the effect of precise anesthesia strategy on perioperative hemodynamics,cognitive function and pain in breast cancer patients undergoing general anesthesia.Methods A total of 80 patients who were admitted to Nanchang People's Hospital from October 2021 to October 2023 and planned to undergo general anesthesia for breast cancer were selected as the research objects.The patients were divided into control group(42 cases)and precision anesthesia group(38 cases)according to the anesthesia plan selected by the patients.The control group was given routine anesthesia monitoring scheme,and the precision anesthesia group was given precision anesthesia monitoring and regulation strategy.The hemodynamic changes of the two groups during the operation were analyzed,and the cognitive function(mini-mental state examination[MMSE])and pain(visual analogue scale[VAS])were compared between the two groups during the perioperative period.Results During the operation,the total incidence of blood flow disorder in the precision anesthesia group(13.16%)was lower than that in the control group(38.10%),and the difference was statistically significant(P<0.05).The MMSE scores of the two groups at 24 h(T_(1))and 48 h(T_(2))after operation were lower than those before operation(T_(0)),and the MMSE scores of the two groups at T_(2) were higher than those at T_(1),and the differences were statistically significant(P<0.05).The MMSE scores at T_(1) and T_(2) in the precision anesthesia group were higher than those in the control group,and the differences were statistically significant(P<0.05).The VAS scores of the two groups at T_(1) and T_(2) were higher than those at T_(0),and the VAS scores of the two groups at T_(2) were lower than those at T_(1),and the differences were statistically significant(P<0.05).The VAS scores of the precision anesthesia group at T_(1) and T_(2) were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Precise anesthesia strategy for breast cancer patients undergoing general anesthesia can reduce the effect of anesthesia on cognitive function and control the degree of pain.