血浆靶控输注舒芬太尼与丙泊酚应用于乳腺癌手术麻醉效果观察.docVIP

血浆靶控输注舒芬太尼与丙泊酚应用于乳腺癌手术麻醉效果观察 　　摘 要 目的 分析靶控输注舒芬太尼和丙泊酚对乳腺癌根治术患者的麻醉效果。方法 选取择期行乳腺癌根治术患者60例，随机分为观察组和对照组（n=30），观察组靶控输注3ug/mL丙泊酚和0.3ng/mL舒芬太尼，对照组微量泵持续泵注入3ug/mL丙泊酚和4ng/mL瑞芬太尼。结果 观察组在插管2min时的HR及MAP与靶控平衡时无显著差异（P0.05）；对照组在插管5min时的HR及MAP显著高于靶控平衡时（P0.05）；插管后，观察组的BIS值显著低于对照组（P0.05）；观察组的苏醒质量明显优于对照组，且不良反应率较低（P0.05）。结论 靶控输注舒芬太尼和丙泊酚能更好地维持乳腺癌患者手术麻醉诱导时的血流动力学平衡，不良反应少，且可增强丙泊酚所具有的镇静作用。 　　关键词 靶控输注 舒芬太尼 丙泊酚 乳腺癌 　　Abstract Objective To analyze the effects of target-controlled infusion of sufentanil and propofol on the breast cancer patients undergoing surgery. Methods 60 breast cancer patients were enrolled and divided into observation group and control group randomly. The observation group was administered with a target-controlled infusion 3ug/ml propofol and 0.5ug/ml sufentanil.And the control group was performed using the continuous pump injection 3ug/ml propofol and 4ng/ml remifentanil by micro pumps. Results In the control group，HR and MAP 5 minutes post-intubation were significantly higher than those after the target controlled balance （P 0.05）.After intubation， the BIS value of the the observation group was significantly lower than that in the control group （P 0.05）； emergence quality of the the observation group was significantly better than that of the control group， and the adverse reaction rate was significantly lower （P 0.05）. Conclusion Target-controlled infusion of sufentanil and propofol can maintain the hemodynamic balance of the breast cancer patients in the induction of anesthesia more profitably and have less adverse reaction and could enhance the sedative effect of propofol. 　　Key words Target-controlled infusion； Sufentanil； Propofol； Breast cancer 　　静脉靶控输注（TCI）通过调整血浆或者效应室浓度来维持机体药物浓度的稳定性，以更好地控制麻醉深度，提供平稳的麻醉维持[1]，临床上广泛应用，且效果良好[2，3]。舒芬太尼已广泛应用于临床麻醉，在全麻诱导、术中维持、术后镇痛等方面都有很好效果[4，5]。瑞芬太尼作用强且起效快，靶控输注6min效应室浓度就能与血浆浓度基本达到平衡。乳腺癌患者术后疼痛可以引起患者应激反应加重，并导致术后免疫功能障碍。为研究靶控输注舒芬太尼和丙泊酚对于乳腺癌根治术患者麻醉效果影响，选取2010年1月至2012年12月在我院行择期行手术治疗的60例乳腺癌患者进行研究，现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　选取2010年1月至20