摘要
目的探讨脑电双频指数(BIS)监测在乳腺癌改良根治术麻醉中的应用价值。方法根据术中监测方式的不同将106例乳腺癌改良根治术患者分为对照组和观察组,每组53例,对照组通过监测心率(HR)、血压等控制麻醉深度,观察组通过监测BIS控制麻醉深度。比较麻醉前(T_(1))、气管插管后(T_(2))、手术结束时(T_(3))、麻醉药物停用1 min后(T_(4))两组患者的HR、收缩压(SBP)、舒张压(DBP)。比较两组患者的麻醉药物使用量、拔管时间、恢复定向力时间、苏醒时间。比较术前、术后24 h、术后48 h两组患者的认知功能[简易精神状态量表(MMSE)]和镇静情况(Ramsay镇静评分法)。结果T_(2)、T_(3)、T_(4)时刻,观察组患者的SBP、DBP、HR均明显低于对照组,差异均有统计学意义(P<0.01)。观察组患者维库溴铵、瑞芬太尼、丙泊酚用量均明显少于对照组,拔管时间、恢复定向力时间、苏醒时间均明显短于对照组,差异均有统计学意义(P<0.01)。术后24、48 h,观察组患者的MMSE评分均明显高于对照组,Ramsay评分均明显低于对照组,差异均有统计学意义(P<0.01)。结论乳腺癌改良根治术中通过监测BIS控制麻醉深度,不仅可维持血流动力学稳定,还能减少麻醉药物用量,缩短术后恢复时间,促进患者认知功能恢复,同时具有良好的镇静效果。
Objective To analyze the application value of bispectral index(BIS)monitoring in anesthesia for modified radical mastectomy of breast cancer.Method A total of 106 patients treated with modified radical mastectomy for breast cancer were selected and divided into control group(n=53)and observation group(n=53)according to different monitoring methods.The depth of anesthesia was controlled by heart rate(HR)and blood pressure monitoring in control group,and by BIS monitoring in the observation group.The HR,systolic blood pressure(SBP)and diastolic blood pressure(DBP)of T_(1)(before anesthesia),T_(2)(after tracheal intubation),T_(3)(at the end of the operation),and T_(4)(1 min after the anesthetic drug was stopped)were compared between the two groups.The anesthetic drug consumption,extubation time,recovery time of orientation,recovery time were compared between the two groups.The cognition[mini-mental state examination(MMSE)]and sedation(Ramsay sedation scale)before operation,24 and 48 hours after operation were compare between the two groups.Result The SBP,DBP and HR at T_(2),T_(3) and T_(4) in the observation group were lower than those in the control group,the differences were statistically significant(P<0.01).The dosages of vecuronium bromide,remifentanil and propofol in the observation group were less,and the extubation time,recovery time of orientation,and recovery time were shorter than those in the control group,the differences were statistically significant(P<0.01).At 24 and 48 hours after operation,the scores of MMSE were higher and the Ramsay scores were lower in the observation group than those in the control group,the differences were statistically significant(P<0.01).Conclusion The BIS monitoring can achieve control of anesthesia depth in modified radical mastectomy of breast cancer,maintain the stability of hemodynamics,reduce the dosage of anesthetic drugs,shorten the postoperative recovery time and promote the recovery of cognition with good sedative effect.
作者
翟淑敏
乔迎帅
袁静
ZHAI Shumin;QIAO Yingshuai;YUAN Jing(Department of Anesthesia and Perioperative Medicine,Affiliated Cancer Hospital of Zhengzhou University/He’nan Cancer Hospital,Zhengzhou 450000,He’nan,China)
出处
《癌症进展》
2022年第22期2318-2321,共4页
Oncology Progress
关键词
脑电双频指数
乳腺癌
改良根治术
麻醉深度
bispectral index
breast cancer
modified radical mastectomy
depth of anesthesia
