The Effect Of Two Type Of Anesthesia On Blood Gas Analysis In Breast Conserving Surgery

Objective: To evaluate clinical effects of continuous sufentanil infusion intravenous anesthesia used in breast conserving surgery for breast cancer, compare with ropivacaine epidural anesthesia. In order to find a better method for breast conserving surgery anaesthesia.Methods: In this randomized controlled study, thirty-eight ambulatory adult female patients in ASAⅠorⅡphysical status scheduled for breast conserving surgery were randomized and divided into two groups. Their ages ranged from 17 to 48, were randomly divided into two groups: group sufentanil (groupⅠ,n=19) and group epidural (groupⅡ,n=19). In both groups atropine 0.05mg was given half an hour before the operation. For groupⅠ, 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 infusion in ten minutes, maintained with sufentail 0.2~0.3μg/kg/h and propofol 3~4mg/kg/h through infusion pump. GroupⅡwas received 0.5% ropivacaine, followed by midazolam 0.08mg/kg and propofol 3~4mg/kg/h through infusion pump. During the operation, arterial blood gas analysis (pH,PaCO2,PaO2 ), 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 during and after operation was observed intensively.Result: All patients in two group fell asleep calmly with no pain,no fidge. In two groups, BP and HR was decreased in some degree after anesthesia, only in group II, at 15min after anesthesia, BP and HR was significantly decreased compared with that of pre-anesthesia(P<0.05), also had a significant meaning compare with group I (P<0.05). RF decreased and TV compensatorily increased after anesthesia, but within normal limits. SpO2 was above 95% stably. In both group pH,PaCO2,PaO2 are within normal limits, but we noticed that PaCO2 had upward tendency. In Group I, the rigor of chest wall muscle was not found. Glossocoma occurred in 3 patients in group I and in 4 patients in group II respectively, requiring oropharynx air tube. In group II, Horner's sign occurred in 9 patients during operation. vomiting and nausea happen in 1 case in group I and 3 case in group II. There was no difference between two groups on revival time. The patients were quiet after revival,without mental syndrome.Conclusion: Compare with epidural anesthesia, continuous sufentanil infusion intravenous anesthesia used upon breast conserving surgery for breast cancer, result in a better hemodynamic state, the patients were safer, more comfortable, complication was fewer, and the anesthesia manipulation was more convenient, complete analgesia can be achieved, and got a similar arterial blood gas analysis result compare with epidural anesthesia. But from the blood gas analysis, slight respiratory depression can be noticed, so intense monitoring is necessary.