The Application Of Sufentanil In The Anesthesia Of Breast Operation

Objective: To evaluate clinical effects of sufentanil based total intravenous anesthesia and epidural anesthesia with ropivacaine in breast operation in a randomized controlled study.Methods: Forty ambulatory adult patients in ASAⅠandⅡphysical status scheduled for breast operation were randomized and divided into two groups. 15 cases for benign mammary mass insection, and the other 25 cases for radical operation of malignant breast cancer. Their ages ranged from 18 to 65. In both groups atropine 0.05mg was given half an hour before operation. For group sufentanil, the induced anesthesia was infused by 500ml colloid fluid, acompanied by midazolam 0.08mg/kg for sedation, followed by sufentanil 0.2μg/kg and ketamin 1mg/kg slowly in ten minutes, maintained with sufentail 0.2-0.3μg/kg/h and propofol 3-4mg/kg/h through TCI. Group epidural was received 0.45% ropivacaine , followed by midazolam 0.08mg/kg and propofol 3-4mg/kg/h through TCI. During the opetation, HR (heart rate)﹑BP (blood pressure)﹑SpO2﹑RF (resparitory frequency)﹑TV (tidal volume) were observed, as well as the dosage of used medicine (ephedrine﹑atropine﹑colloid fluid) were recorded. Complication in and post operation was observed intensively.Result: Complete analgesia and sedation were achieved. In both groups, BP post anesthesia was significantly decreased prepared with that of pre-anesthesia. HR decreased after anesthesia, but withoutstatistical meanings. RF decreased and TV increased after anesthesia, but within normal limits. Spo2 was above 95% stably. In Group suf, the rigor of chest wall muscle was not found. Glossocoma occurred in four patients in group suf and in two patients in group epidural respectively, requiring oropharynx air tube. In group epidural, Horner's sign occurred in seven patients during operation. For both groups, vomiting and nausea didn't happen. There was no difference between two groups on revival time. The patients were quiet after revival without mental syndrome.Conclusion: When sufentanil combined with intravenous anesthesia was used on breast operation, the patients were safer, anesthesia manipulation was more convenient, complication was fewer, and comfortable, complete analgesia can be achieved, compared with simple epidural anesthesia.