Effect Of Different Doses Of Naloxone Combined With Dezocine On Postoperative Analgesia In Patients With Breast Cancer

Objective:1.To investigate the effects of different doses of naloxone combined with dezocine on the recovery time,the removal time of laryngeal mask and the hemodynamics during removal of laryngeal mask of breast cancer patients;2.To study the effects of different doses of naloxone combined with dezocine on postoperative analgesia in patients with breast cancer;3.To study the effects of different doses of naloxone combined with dezocine on postoperative sedation in patients with breast cancer;4.To observe the effects of different doses of naloxone combined with dezocine on postoperative adverse reactions in patients with breast cancer.Methods:120 patients with unilateral radical mastectomy were selected from the Cancer Hospital of Tianjin Medical University from 2018.9 to 2019.2.The patients were divided into four groups by random number table.Non-invasive blood pressure,heart rate,ECG,oxygen saturation,and depth of anesthesia were monitored after the patient entered the operating room;Anesthesia induction intravenous administration of0.03mg/kg midazolam,0.5?g/kg sufentanil,0.6mg/kg rocuronium,2mg/kg propofol,pre-oxygenated for 3-5min,placed in the laryngeal mask,mechanical ventilation,ventilation mode,tidal volume is set to 6-8ml/kg,suction ratio 1:2,respiratory rate12-14 times/min;anesthesia maintenance:propofol 5-7mg/kg/h,remifentanil6-8?g/kg/h continuous pumping.Intermittent administration of rocuronium 0.3mg/kg to ensure BIS is 40-60,monitoring the difference of blood pressure and heart rate within 20%compared with indoor level.SpO₂ is in the normal range of 95%-100%.15 minutes before the end of the operation,different doses of drugs were given according to different groups:Group L:Dezocine 0.15 mg/kg+naloxone 0.5?g/kg;Group M:Dezocine 0.15 mg/kg+naloxone 1.0?g/kg;Group H:Dezocine 0.15mg/kg+naloxone 1.5?g/kg;Group C:Dezocine 0.15 mg/kg+equal volume of normal saline.At the end of the operation,ondansetron 4mg was given.After awake,the patient's spontaneous breathing was restored,and the tidal volume reached6-8ml/kg,sucked sputum,then removed the laryngeal mask,transferred patients into PACU.When the vital signs were stable,the patients can be returned to the ward.The age,ASA grade,BMI,length of operation,and surgical site of groups were recorded;The time of awakening and extubation,the blood pressure and heart rate at the end of surgery?Ta?,extubation?Tb?and 5 min?Tc?after extubation were recorded;Visual analogue scale?VAS?,Bruggrmann comfort score?BCS?,Ramsay sedation scores at 1 h?T1?,6 h?T2?,12 h?T3?,and 24 h?T4?after operation were recorded;The incidence of adverse reactions and remedial analgesia were recorded.Results:1.The time of awakening and extubation in three treatment groups were shorter than the group C,the group M had the shortest awakening time?P<0.05?;The difference of hemodynamic fluctuations of the four groups during the removal of laryngeal mask were not obvious?P>0.05?;2.The VAS of the patients in the group M at T1,T2,T3 were lower than the other three groups?P<0.05?;The BCS of treatment groups at T1 were higher than group C;The remedial analgesia in treatment groups were less than group C?P<0.05?;3.The treatment groups'Ramsay sedation at T1 were lower than group C?P<0.05?;4.The postoperative adverse reactions in treatment groups were less than group C?P<0.05?,the group M had the least number,especially.Conclusion:1.1.0?g/kg of naloxone combined with dezocine in patients with radical mastectomy can shorten the patient's awakening and laryngeal mask removal time;2.1.0?g/kg of naloxone combined with dezocine in patients with radical mastectomy can enhance the postoperative analgesia effect of dezocine;3.Low-dose naloxone combined with dezocine in patients with radical mastectomy can enhance the postoperative sedation effect to a certain extent;4.Low-dose naloxone combined with dezocine in patients with radical mastectomy can reduce the incidence of postoperative adverse reactions.