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  

Comparation of the Effect of Sedation of Dexmedetomidine and Propofol on Patients with Breast Cancer Surgery

作　　者：屈航英 蔡惠[2] 

机构地区：[1]陕西中医药大学,咸阳712000 [2]西安交通大学第一附属医院,西安710061

出　　处：《基因组学与应用生物学》2017年第2期477-481,共5页Genomics and Applied Biology

基　　金：国家自然科学基金(No.81502295)资助

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_2<94%)、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(p>0.05),C组术后呼吸抑制发生率明显小于E组(p<0.01),且恶心呕吐及寒战不适的发生率也显著低于E组患者(p<0.05);同时,与E组相比,C组的术后镇痛满意率显著提高(p<0.05)。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(p>0.05)。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(p<0.05)。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。This research was designed to compare the effect of sedation of dexmedetomidine and propofol on patients treated by total intravenous anesthesia in breast cancer surgery and their influence on the inflammatory factor in perioperative period. 60 patients undergoing radical mastectomy were divided into two groups： dexmedetomidine group （group C） and propofol group （group E） （n=30） according to random number table, which were both treated by total intravenous anesthesia （TIVA）. In group C, dexmedetomidine was used in intravenous maintenance in anesthesia while propofol was used in that in group E. The BIS monitoring score represented patients intraoperative sedation degree, intraoperative awareness rate, incidence of postoperative respiratory inhibition （postoperation SPO2〈94%）, incidence of nausea and vomiting, incidence of chills and discomfort and satisfaction rate of postoperative analgesia were recorded. The changes of TNF-α, IL-6, CRP in peripheral blood at 10 min before anesthesia induction （T1） and 30 min after surgery （T2） were compared respectively. There was no significant difference in intraoperative sedation degree of BIS monitoring score and intraoperative awareness rate of the two groups （p 〉0.05）, but the incidence of postoperative respiratory inhibition in group C was lower than that of E group （p〈0.01）, and the incidence of nausea and vomiting and the incidence of chills and discomfort in group C were significantly lower than those in group E （p〈0.05）. Meanwhile, compared with group E, satisfaction rate of postoperative analgesia of group C significantly improved. The levels of TNF-α, CRP, and IL-6 in two groups at T1 time point had no significant difference （p〉0.05）. However, the levels of TNF-α, CRP, and IL-6 in group C were lower than those in group E, and the difference was statistically significant （p〈0.05）. Dexmedetomidine, as a sedative, is much more suitable than propofol in TIVA for breast cancer, which can reduce the stress

关 键 词：盐酸右美托咪定 丙泊酚 乳腺癌 舒适度 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]