摘要
目的观察精准化麻醉策略对老年乳腺癌术后疼痛程度及认知功能损伤的影响。方法选取2021年6月至2023年10月南昌市人民医院麻醉科进行乳腺癌手术的80例老年乳腺癌患者为研究对象,采用随机数字表法分为对照组与观察组,各40例。对照组采用常规麻醉,观察组采用精准化麻醉策略,比较两组围手术期指标(包括手术时间、术时失血量、手术部位、丙泊酚用量)、术后疼痛程度[视觉模拟评分法(VAS)]及认知功能损伤情况[简易智能精神状态检查量表(MMSE)]。结果两组手术时间、术时失血量、手术部位比较,差异无统计学意义(P>0.05),观察组术时丙泊酚用量低于对照组,差异有统计学意义(P<0.05)。观察组患者术后1h、12 h、1d VAS评分均低于对照组,差异有统计学意义(P<0.05)。术前及术后3 d两组MMSE评分比较,差异无统计学意义(P>0.05),术后1d观察组MMSE评分高于对照组,差异有统计学意义(P<0.05)。结论在老年乳腺癌患者手术中使用精准化麻醉策略可明显降低术时麻醉药物使用量,降低术后疼痛程度,同时对患者认知功能损伤较小。
Objective To observe the effect of precise anesthetic strategy on postoperative pain and cognitive impairment in elderly patients with breast cancer.Methods A total of 80 elderly patients with breast cancer who underwent breast cancer surgery in the Department of Anesthesiology,Nanchang People's Hospital from June 2021 to October 2023 were selected as the study objects,and they were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was given conventional anesthesia,while the observation group was given precise anesthesia.The perioperative indicators,postoperative pain degree(visual analogue scale[VAS])and cognitive impairment(mini mental state examination[MMSE]).Results There was no significant difference in operation time,blood loss and oper-ation site between the two groups(P>0.05).The dosage of propofol in the observation group was lower than that in the con-trol group(P<0.05).The VAS scores of observation group at 1 h,12 h and 1 d after operation were lower than those of con-trol group(P<0.05).There was no significant difference in MMSE score between the two groups before and 3 days after surgery(P>0.05),but the MMSE score in the observation group was higher than that in the control group 1 day after surgery,and the difference was statistically significant(P<0.05).Conclusion Applying precise anesthetic strategy in surgery for elderly patients with breast cancer can significantly reduce intraoperative dosage of anesthetic and relieve post-operative pain,with little damage to cognitive function.
作者
彭娇梅
王凯
付辉凡
胡静
徐鸣
陈琳
PENG Jiaomei;WANG Kai;FU Huifan;HU Jing;XU Ming;CHEN Lin(Department of Anesthesiology,Nanchang People's Hospital,Jiangxi Province,Nanchang 330000,China)
出处
《中国当代医药》
CAS
2024年第30期78-81,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(SKJP220203992)。
关键词
精准化麻醉策略
老年乳腺癌
术后疼痛
认知功能损伤
Precise anesthetic strategy
Elderly breast cancer
Postoperative pain
Cognitive impairment
