CAJ | 학술논문

目的：探讨硬膜外麻醉乳腺癌手术时瑞芬太尼的应用以及不同浓度情况下的手术效果。方法选取120例乳腺癌择期手术患者，随机分为实验组（A组）和对照组（B组），各60例。实验组随机分为A1、A2、A3，每小组各20例。对照组行硬膜外麻醉，实验组A1、A2、A3于麻醉10 min后微泵持续滴注不同浓度的瑞芬太尼，于手术结束前10 min停止泵入。对2组情况进行观察、统计，并判定结果。结果 A组比B组手术效果好，2组比较差异具有统计学意义（ P＜0．05）；A组中A2组效果更好。结论瑞芬太尼用于乳腺癌手术硬膜外麻醉患者术中血压波动小、体动少且术后苏醒快；在中等剂量浓度下使用瑞芬太尼更加安全有效，血流动力学更加稳定。
목적：탐토경막외마취유선암수술시서분태니적응용이급불동농도정황하적수술효과。방법선취120례유선암택기수술환자，수궤분위실험조（A조）화대조조（B조），각60례。실험조수궤분위A1、A2、A3，매소조각20례。대조조행경막외마취，실험조A1、A2、A3우마취10 min후미빙지속적주불동농도적서분태니，우수술결속전10 min정지빙입。대2조정황진행관찰、통계，병판정결과。결과 A조비B조수술효과호，2조비교차이구유통계학의의（ P＜0．05）；A조중A2조효과경호。결론서분태니용우유선암수술경막외마취환자술중혈압파동소、체동소차술후소성쾌；재중등제량농도하사용서분태니경가안전유효，혈류동역학경가은정。
Objective To investigate the clinical value of different concentrations of remifentanil in epidural anesthesia of mastectomy.Methods 120 mastocarcinoma patients were randomly divided into the experimental group (group A) and the control group(group B),each group was 60.The experimental group was divided into group A1-A3,each group was 20.The con-trol group underwent epidural anesthesia after routine inspection .Group A1-A3 receivedcontinuous infused remifentanil by mi-cropump in different concentrations 10min after epidural anesthesia ,and stopped 10min pumped before the surgery ended .The sit-uation and statistics of the 2 groups were observed .Results Group A had better effect than group B , there was significantly difference between the 2 groups(P<0.05).Remifentanil in group A2 was better.Conclusion Using remifentanil in epidural an-esthesia of mastectomy has small intraoperative blood pressure fluctuation ,less body movement and faster postoperative recovery . Remifentanil is safer ,more effective and has more stable hemodynamic in moderate doses of concentration .