盐酸右美托咪定及丙泊酚用于乳腺癌根治术中的镇静作用比较

发布时间：2018-12-10 21:43

【摘要】：比较盐酸右美托咪定及丙泊酚用于全凭静脉麻醉乳腺癌根治术患者术中镇静作用及对围术期炎症因子的影响。选择择期行乳腺癌根治术患者60名,用随机数字表法分为两组:盐酸右美托咪定组(C组)和丙泊酚组(E组)(n=30),两组均采用全凭静脉麻醉(TIVA)。其中C组在麻醉中采用盐酸右美托咪啶静脉维持;E组在麻醉中采用丙泊酚静脉维持。记录患者术中镇静程度BIS监测评分、术中知晓率、术后呼吸抑制发生率(术后SPO_294%)、恶心呕吐发生率、寒战不适发生率和术后镇痛的满意率,分别比较麻醉诱导前10 min(T1)、术后30 min(T2)2时间点外周血中TNF-α、IL-6、CRP的变化情况。两组患者术中镇静程度BIS监测评分及术中知晓率无显著差异(p0.05),C组术后呼吸抑制发生率明显小于E组(p0.01),且恶心呕吐及寒战不适的发生率也显著低于E组患者(p0.05);同时,与E组相比,C组的术后镇痛满意率显著提高(p0.05)。两组患者T1时刻的TNF-α、CRP、IL-6水平比较,差异无统计学意义(p0.05)。组间比较,C组T2时刻TNF-α、CRP、IL-6水平低于E组,差异有统计学意义(p0.05)。盐酸右美托咪定较丙泊酚更适用于全凭静脉麻醉乳腺癌根治术的镇静,且有利于降低围术期应激反应,提高患者舒适度。
[Abstract]:To compare the effect of dexmetomidine hydrochloride and propofol on postoperative sedation and perioperative inflammatory factors in patients with breast cancer undergoing total intravenous anesthesia. Sixty patients undergoing elective radical mastectomy for breast cancer were randomly divided into two groups: dexmetidine hydrochloride group (group C) and propofol group (group E) (n = 30). Both groups were treated with total intravenous anesthesia (TIVA). The intravenous maintenance of dexmetidine hydrochloride was used in group C and propofol was used in group E. The BIS score of sedation, the rate of awareness, the incidence of postoperative SPO_294%, nausea and vomiting, shivering and discomfort, and the satisfaction rate of postoperative analgesia were recorded. The changes of TNF- 伪 and IL-6,CRP in peripheral blood were compared at 10 min (T1) before anesthesia induction and 30 min (T2) 2 postoperatively. There was no significant difference between the two groups in the BIS score of sedation during operation and the awareness rate during operation (p0.05), C). The incidence of postoperative respiratory depression in group E was significantly lower than that in group E (p0.01). The incidence of nausea and vomiting and shivering discomfort was significantly lower in group E than in group E (p0.05). At the same time, compared with group E, the satisfaction rate of postoperative analgesia in group C was significantly higher than that in group E (p 0.05). There was no significant difference in TNF- 伪 and CRP,IL-6 levels between the two groups at T 1 (p 0. 05). The levels of TNF- 伪 and CRP,IL-6 in group C were significantly lower than those in group E at T 2 (p0.05). Compared with propofol, dexmetidine hydrochloride is more suitable for sedation of breast cancer under total intravenous anesthesia. It is also helpful to reduce perioperative stress reaction and improve patients' comfort.
【作者单位】：陕西中医药大学;西安交通大学第一附属医院;
【基金】：国家自然科学基金(No.81502295)资助
【分类号】：R614;R737.9

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