喉罩联合无肌松全麻在老年乳癌根治术中的应用

目的研究喉罩联合无肌松全麻对老年乳癌根治术中应激反应的影响。方法选择老年乳癌根治术患者80例,随机分为气管插管肌松全麻组（A组）、喉罩联合无肌松全麻组（B组）,每组各40例。观察两组各时间点的平均动脉压（MAP）、心率（P）、心率收缩压乘积（RPP）、脉搏血氧饱和度（SpO2）,对比两组呛咳、躁动等拔管反应以及丙泊酚、瑞芬太尼使用量、术后拔管（拔除喉罩）时间。结果 A组术中各时间点MAP、P、RPP较术前显著增加（P〈0.05）;B组各时间点MAP、P、RPP较术前差异无统计学意义（P〉0.05）,A组术中各时间点MAP、P、RPP高于B组（P〈0.05）;A组呛咳、躁动评分高于B组（P〈0.05）;A组术中丙泊酚、瑞芬太尼用量高于B组;A组拔管时间长于B组（P〈0.05）。结论在老年乳癌根治术中采用喉罩联合无肌松全麻技术可降低围术期应激反应,减少麻醉药物用量,缩短术后复苏时间。

Laryngeal mask combined with general anesthesia without muscle relaxant applied in radical operation of breast cancer in elderly patients

Objective To study the effect of laryngeal mask combined with general anesthesia without muscle relaxant on stress reaction of elderly breast cancer radical operation.MethodsEighty cases elderly patients with breast cancer were randomly divided into intubation muscle relaxant anesthesia group（group A）and laryngeal mask combined with any muscle relaxant anesthesia group（group B）,each group had 40 cases.The mean arterial pressure（MAP）,heart rate（P）,the rate pressure product（RPP）,pulse oxygen saturation（SpO2）of the two groups at the point of each time were observed,two groups of extubation reaction such as cough,agitation,the usage of general anesthesia drug and the extubation（laryngeal mask）time after the operation were compared.Results The result of MAP,P,RPP at the point of each time in group A were significantly increased（P〈0.05）;the result of MAP,P,RPP at the point of each time in group B were no significantly different（P〉0.05）,each result of the point of each time in group A were higher than group B（P〈0.05）;cough and agitation in group A were more severe than those in group B（P〈0.05）;the usage of propofol,remifentanil in group A was much higher than group B;the extubation time of group A was much longer than group B（P〈0.05）.Conclusion In elderly patients with radical mastectomy of breast cancer,laryngeal mask combined with general anesthesia without muscle relaxation technique can reduce the perioperative stress response,reduce drug dosage,shorten the recovery time after operation.