UNASSIGNED:研究瑞芬太尼复合右美托咪定对乳腺癌改良根治术(MRM)患者的镇痛效果及围手术期T淋巴细胞亚群的影响。
UNASSIGNED:80例乳腺癌患者根据麻醉方案分为对照组和研究组。对照组给予瑞芬太尼进行麻醉诱导和维持,研究组患者给予瑞芬太尼和右美托咪定进行麻醉诱导和维持。我们比较了麻醉时间,操作时间,手术失血,术后唤醒时间,拔管时间,不良反应发生率,两组患者外周血VAS评分及T淋巴细胞亚群。
未经评估:基线数据包括年龄,高度,体重和BMI,ASA分类,乳腺癌的阶段,新辅助治疗的频率,和手术特点,包括麻醉时间,两组手术时间、术中出血量比较差异均无统计学意义(P>0.05)。与对照组相比,研究组患者苏醒时间和拔管时间均显著缩短(P<0.05),研究组负荷剂量右美托咪定后MBP和HR显著下降(P<0.05)。研究组患者术后4、8、12、16、20、24h的VAS评分均显著低于对照组(P<0.05)。麻醉诱导前,CD4+比值无显著差异,两组间外周血CD8+和CD4+/CD8+T淋巴细胞比较(P>0.05)。术中1h及术后24h,研究组CD4+和CD4+/CD8+细胞比例明显高于对照组(P<0.05),而CD8+细胞比例低于对照组(P<0.05)。
未经批准:对于接受MRM的乳腺癌患者,瑞芬太尼复合右美托咪定可增强术后镇痛效果,降低术后免疫抑制。
UNASSIGNED: To study the analgesic effect of breast cancer patients undergoing modified radical mastectomy (MRM) and the influence of perioperative T lymphocyte subsets by remifentanil combined with dexmedetomidine.
UNASSIGNED: 80 breast patients were divided into control group and research group based on the anesthesia protocol. Patients in control group was given remifentanil for anesthesia induction and maintenance, and patients in research group was given remifentanil and dexmedetomidine for anesthesia induction and maintenance. We compared the anesthesia time, operation time, surgical blood loss, postoperative wake-up time, extubation time, incidence of adverse reactions, VAS score and T lymphocyte subsets in peripheral blood in the two groups of patients.
UNASSIGNED: The baseline data including age, height, weight and BMI, ASA classification, stage of breast cancer, frequency of neoadjuvant therapy, and surgical characteristics including anesthesia time, operation time and bleeding volume all have no significant difference between two groups (P > 0.05). Compared to control group, the time of wake up and extubation in patients of research group were all significantly decreased (P < 0.05), and significantly decreased MBP and HR after loading dose of dexmedetomidine in research group (P < 0.05). The VAS scores of patients at 4, 8, 12, 16, 20 and 24 h after surgery in the research group are all significantly lower than those in the control group (P < 0.05). Before induction of anesthesia, there was no significant difference in the ratio of CD4+, CD8+ and CD4+/CD8+ T lymphocytes in peripheral blood between the two groups (P > 0.05). At 1 h during operation and 24 h after operation, the ratio of CD4+ and CD4+/CD8+ cells in the research group was significantly higher than these of the control group (P < 0.05), while the ratio of CD8+ cells was lower than that of the control group (P < 0.05).
UNASSIGNED: For breast cancer patients undergoing MRM, the use of remifentanil combined with dexmedetomidine can enhance postoperative analgesia and reduce postoperative immunosuppression.