摘要
目的:观察右美托咪定用于乳腺癌前哨淋巴结活检术的临床效果。方法:选择35～62岁、美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级拟行乳腺癌前哨淋巴结活检术的患者180例,随机分为D组、M组、C组,各60例。D组局麻前给予右美托咪定1μg/kg,术中0.5μg(/kg·h)维持;M组局麻前给予咪达唑仑0.1mg/kg,术中0.05mg(/kg·h)维持;C组则在局麻前给予等量的生理盐水。记录3组患者入室后(T0)、麻醉后1min(T1)、切皮时(T2)、切皮后5min(T3)、切皮后30min(T4)以及手术结束时(T5)的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼吸频率(RR),并在术后对患者进行VAS及Ramsay评分。结果:在T1、T2、T3、T4、T5时间点,D组的VAS和Ramsay评分与M组和C组比较差异有统计学意义(P<0.05);D组的MAP和HR均低于M组和C组(P<0.05);SpO2和RR在D组、M组、C组之间比较差异无统计学意义(P>0.05)。在T1、T2、T3、T4、T5时间点,D组的VAS和Ramsay评分、MAP和HR与T0比较差异有统计学意义(P<0.05)。结论:右美托咪定辅助局麻行乳腺癌前哨淋巴结活检术,可产生满意的镇静和镇痛作用,有效维持患者术中的循环稳定,提高手术的安全性。右美托咪定在心动过缓的患者中应慎用。
OBJECTIVE： To observe the clinical effect of dexmedetomidine on sentinel lymph node biopsy （SLNB） in breast cancer. METHODS： 180 patients, aged 35 to 62, ASA Ⅰ or Ⅱ, scheduled sentinel lymph node biopsy of breast cancer, were equally randomized into group D, M and C with 60 cases in each group. Group D was given dexmedetomidine 1 μg/kg betbre local anesthesia, maintained with 0.5 μg/（kg·h）; group M was given midazolam 0.1 mg/kg betbre local anesthesia, maintained with 0.05 mg/ （kg·h）; group C was given normal saline before local anesthesia. The changes of MAP （mean arterial pressure）, HR （heart rate）, SpO2 and RR （respiratory） were observed and recorded at the time of inter-room （T0）, 1 min after anesthesia （T1）, at the time of incision （T2）, 5 rain after incision （T3）, 30 rain after incision （T4） and at the end of operation （T5）. VAS score and Ramsay scores of all patients were conducted after operation. RESULTS： At T1, T2, T3, T4 and T5, there was statistical significance in VAS score and Ramsay scores between group D and group M or C （P〈0.05） ; MAP and HR of group D were lower than in group M or group C （P〈0.05） ; SpO, and RR of 3 groups had no significant differences （P〉0.05）. In group D, the VAS score and Ramsay scores, MAP and HR at T1, T2, T3, T4 and T5 had significant difference from at T0 observation point （P〈0.05）. CONCLUSIONS： In sentinel lymph node biopsy of breast cancer, dexmedetomidine with good sedative and analgesic effect, can effectively sustain the stability of cardiovascular system during operation and improve the safety of the SLNB. And midazolam should be cautiously used for patients with bradycardia.
出处
《中国药房》
CAS
CSCD
2013年第10期921-922,共2页
China Pharmacy
关键词
右美托咪定
乳腺癌
前哨淋巴结
Dexmedetomidine
Breast neoplasms
Sentinel lymph node
