Abstract：Objective: To observe the effect of sevoflurane combined with propofol inhalation duration on postoperative cognitive function in patients with radical mastectomy.Methods: 104 cases of breast cancer patients who underwent surgery in our hospital from August 2016 to August 2019 were selected and randomly divided into observation group and control group, 52 cases in each group. Both groups were given low-flow inhaled sevoflurane and pump propofol for anesthesia maintenance, while continuous intravenous infusion of remifentanil for analgesia.In the control group, sevoflurane was stopped after inhalation for 2h and only pumped propofol was used for anesthesia maintenance. In both groups, all anesthetic drugs were stopped at the time of surgical suture and oxygen supply was given. Observed two groups of patients with connecting electrical double frequency index (BIS) monitor (T0), 3 min after anesthesia induction (T1), 1 min after intubation (T2), cut skin (T3), sewing leather after 1 min after 1 min (T4) BIS index, compared two groups of patients with postoperative spontaneous breathing recovery time, open time, extubation time and language can be stated time, compared two groups of patients before and after 1~12h operation, Montreal cognitive scale (MoCA) score, compared two groups of patients with postoperative hypotension, vomiting, bronchospasm, incidence of adverse reactions such as tachycardia. Results: There was no significant difference in body mass index (BMI), male proportion and man proportion between the two groups, all with P>0.05. The BIS index of two groups of patients changed with time, and the role of time factors varied with different groups, P<0.05; the BIS index at each time pant (T1, T2, T3, T4) in the two groups were significantly decreased, P<0.05; At the same time,there was no significantly difference in T0, T1, T2, T3 between the two groups (P>0.05). The BISindex at T4 in the observation group was significantly higher than that in the control group (P<0.05). The recovery time of spontaneous breathing, eye opening time, extubation time and verbal statement time in the observation group were significantly shorter than those in the control group, P<0.05. MOCA scores of the two groups were changed with time, and the effect of time factor was different with different groups, P<0.05; at the same time, MOCA scores of the observation group at 1h, 6h, 12h after operation were significantly higher than those of the control group, all P<0.05. The total incidence of postoperative adverse reactions in the observation group was not significantly different from that in the control group, P>0.05. Conclusion: The inhalation of sevoflurane for anesthesia during the whole course of radical mastectomy for breast cancer has little impact on the cognitive function of breast cancer patients, and the recovery time of inhalation anesthesia during the whole course is fast, without increasing adverse reactions, which is worthy of clinical promotion.
[1] 陈玲燕,梁力.乳腺外科整复术在乳腺癌保乳手术中的临床应用[J].中国基层医药,2019,26(2):214~216. [2] 赵亚婷,马杰,王雅琪,等.糖尿病对乳腺癌发生及预后的影响[J].河北医科大学学报,2018,38(2):217~220. [3] 陈万青,郑荣寿.中国女性乳腺癌发病死亡和生存状况[J].中国肿瘤临床,2015,42(13):668~674. [4] 孙洪吉,谢越,张晓红,等.蒙特利尔认知评估量表的条目分析[J].中华老年心脑血管病杂志,2014,16(4):387~390. [5] 杨红星,贾国丛,王阳.右美托咪定对乳腺癌根治术患者的麻醉效果及T淋巴细胞亚群的影响分析[J].癌症进展,2018,16(4):103~106. [6] 叶松.七氟醚复合丙泊酚及芬太尼在小儿扁桃体摘除手术麻醉中的应用[J].中华全科医学,2016,14(1):65~67. [7] 万静洁,李真,金宁,等.小剂量七氟醚或笑气复合丙泊酚对宫腔镜术后恶心呕吐的影响[J].中国医科大学学报,2016,45(1):77~79. [8] Zhang H,Wu Z,Zhao X,et al.Role of dexmedetomidine in reducing the incidence of postoperative cognitive dysfunction caused by sevoflurane inhalation anesthesia in elderly patients with esophageal carcinoma[J].Journal of Cancer Research and Therapeutics,2018,14(7):1497~1499.
2021, Vol. 27 
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