右美托咪啶复合丙泊酚在乳腺麦默通微创旋切术中的应用

Application of dexmedetomidine combined with propofol on mammotome operation for breast

目的探讨右美托咪啶复合丙泊酚在乳腺麦默通旋切术中的麻醉效果。方法接受麦默通微创旋切术的乳腺多发实性肿块患者60例,随机分为观察组和对照组,每组各30例。对照组采用丙泊酚麻醉,观察组采用右美托咪定复合丙泊酚麻醉。比较2组患者麻醉开始、手术开始、手术开始后5 min、术毕时的平均动脉压、心率、血氧饱和度,托下颌时间、术后苏醒时间、丙泊酚用量以及术后1 h的视觉模拟(VAS)评分和Ramsay镇静评分。结果 2组各时间点平均动脉压和血氧饱和度差异均无统计学意义(P>0.05)。观察组手术开始、手术开始后5 min、术毕时的心率均低于对照组(P<0.05)。观察组手术开始、手术开始后5 min的心率低于麻醉开始和术毕时(P<0.05)。观察组托下颌时间、苏醒时间和丙泊酚用量均少于对照组(P<0.05)。术后1 h观察组VAS评分低于对照组,2组Ramsay评分差异无统计学意义(P>0.05)。结论乳腺麦默通微创旋切术使用右美托咪定复合丙泊酚静脉麻醉,可减少丙泊酚用量,麻醉效果和术后镇痛效果较好,但能够降低心率,不适用于窦性心动过缓及房室传导阻滞患者。

Objective To investigate the anesthetic effect of dexmedetomidine combined with propofol in mammotome operation for breast.Methods Sixty patients underwent mammotome operation for multiple solid masses in breast were randomly divided into observation group and control group(n=30 for each group). The control group was anesthetized with propofol. The observation group was anesthetized with dexmedetomidine and propofol. Data of blood pressure, heart rate,oxygen saturation, the time of jaw support, the time of postoperative recovery, the amount of propofol at the beginning of anesthesia, the start of surgery, 5 minutes after the start of surgery, the end time of surgery and the VAS score, Ramsay sedation score at 1 hour after surgery were compared between the two groups.Results There were no significant differences in blood pressure and oxygen saturation between the two groups at each time point(P>0.05). The heart rates at the beginning of surgery, 5 minutes after the start of surgery and at the end of surgery were lower in the observation group than those of the control group(P<0.05). The heart rates at the beginning of surgery and 5 minutes after the start of surgery were lower than at the start of anesthesia and the end of surgery in the observation group(P<0.05). The time of jaw support,recovery time and propofol dosage were shorter in the observation group than those in the control group(P<0.05). The VAS score was lower at 1 h after operation in the observation group than that of the control group. There was no significant difference in the Ramsay score between the two groups(P>0.05).Conclusion The use of dexmedetomidine combined with propofol on mammotome operation for breast can reduce the amount of propofol. The effect of anesthesia and postoperative sedation is good, but heart rate decreases, which is not suitable for patients with sinus bradycardia and atrioventricular block.