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目的观察依托咪酯用于乳腺癌手术患者的静脉麻醉维持对患者术后苏醒质量的影响。方法将60例拟在全身麻醉下进行乳腺癌根治术的患者随机分为试验组30例和对照组30例。试验组术中麻醉维持为持续静脉输注依托咪酯10~15μg·kg~(-1)·min~(-1);对照组术中持续输注丙泊酚6~8 mg·kg~(-1)·h~(-1)。记录2组患者睁眼时间、拔管时间、定向力恢复时间,观察患者拔管期血流动力学变化及恶心呕吐、体动等不良反应发生情况。结果试验组和对照组患者停药后睁眼时间和拔管时间差异均无统计学意义(P>0.05);试验组拔管期血流动力学稳定,与对照组比较差异无统计学意义(P>0.05)。试验组恶心、呕吐发生率显著高于对照组(P<0.05)。结论依托咪酯联合瑞芬太尼持续输注用于乳腺癌手术的静脉麻醉维持,不延长患者拔管时间,拔管期血流动力学稳定,苏醒质量满意,对短小手术的静脉维持麻醉是安全的。
Objective To observe the effect of etomidate on the quality of postoperative wakefulness in patients undergoing breast cancer surgery. Methods Sixty patients scheduled for radical mastectomy under general anesthesia were randomly divided into experimental group (30 cases) and control group (30 cases). Intraoperative anesthesia in the experimental group was maintained by intravenous infusion of etomidate 10 ~ 15μg · kg -1 · min -1; in the control group, continuous infusion of propofol 6 ~ 8 mg · kg ~ (-1) -1) · h ~ (-1). The open time, extubation time and recovery time of directional force in the two groups were recorded. The changes of hemodynamics, nausea and vomiting, physical activity and other adverse reactions during the extubation were observed. Results There was no significant difference in open time and extubation time between the experimental group and the control group (P> 0.05). The hemodynamics of the experimental group during extubation were stable and there was no significant difference compared with the control group P> 0.05). The incidence of nausea and vomiting in the experimental group was significantly higher than that in the control group (P <0.05). Conclusion Continuous infusion of etomidate combined with remifentanil for the maintenance of intravenous anesthesia for breast cancer surgery does not prolong the extubation time, stable hemodynamics during extubation, satisfactory quality of recovery and maintenance of intravenous anesthesia for short-term surgery safe.