丙泊酚和瑞芬太尼全静脉麻醉与丙泊酚和异氟醚静吸复合麻醉在乳腺癌根治术中的临床观察

目的：观察丙泊酚和瑞芬太尼全静脉麻醉与丙泊酚和异氟醚静吸复合麻醉在乳腺癌根治术中的影响。方法：选取本院2010年8～10月80例择期行乳腺癌根治术患者,随机分为瑞芬太尼组（R组）和异氟醚组（Ⅰ组）,每组各40例。常规麻醉诱导后,麻醉维持丙泊酚4～6 mg/（kg.h）,R组瑞芬太尼0.05～2.00μg/（kg.min）持续泵入,Ⅰ组异氟醚1.0%～1.5%吸入。观察麻醉诱导后血压、心率变化,苏醒时间,术后疼痛情况,术后恶心呕吐情况。结果：R组术中血流动力学变化较平稳,优于Ⅰ组（P〈0.05）,术后苏醒时间R组短于Ⅰ组（P〈0.05）,术后恶心呕吐R组优于Ⅰ组（P〈0.05）,术后疼痛两组差异无统计学意义（P〉0.05）。结论：丙泊酚和瑞芬太尼持续输注维持全静脉麻醉用于乳腺癌根治术中麻醉平稳,术后苏醒快,术后恶心呕吐较少。

Clinical observation of total intravenous anaesthesia with propol and remifentanil and infusion combined inhalation anaesthesia with propol and isoflurane in radical mastectomy

Objective： To observe the influence of total intravenous anaesthesia with propol and remifentanil and infusion combined inhalation anaesthesia with propol and isoflurane in radical mastectomy.Methods： Eighty patients in radical mastectomy were randomized into two groups with 40 cases each.With general anesthesia induced,propol 4~6 mg/（kg·h） infusion.Group R anesthesia was with remifentanil 0.05~2.00 μg/（kg·min） infusion.Group Ⅰ anesthesia was with 1.0%~1.5% isoflurane inhalation.The variation of blood pressure（Bp） and heart rate（HR） during induction and maintenance,the time of spontaneous breathing recovery,postoperatative complications such as pain and vomiting and nausea,were observed.Results： There were significant difference in the change of Bp and HR during surgery between two groups（P0.05）.The time of tracheal extubation group R was significantly shorter than group Ⅰ（P0.05）.The postoperatative vomiting and nausea group R was significantly better than group Ⅰ（P0.05）.There were no significant difference in pain between two groups（P0.05）.Conclusion： The hemodynamic variables are stable,the consciousness recovery is faster and the vomiting and nausea are better in total intravenous anaesthesia with propol and remifentanil for radical mastectomy.