Effect Of Different Anesthesia In Patients Undergoing Radical Mastectomy

Objective:To compare the different anesthesia in patients undergoing radical mastectomyMethods:Sixty patients undergoing radical mastectomy were randomly divided into three groups general anesthesia(group T,n=20),epidural anesthesia combined with general anesthesia(group T n=20) and epidural anesthesia combined with LMA anesthesia(group T n-20). An epidural cather was inserted at the T3-4 interspace before induction of general anesthesia.Epidural anesthesia was maintained by 0.33% ropivcacine 5ml every hour:midazolam 0.06mg/kg fentanil 4μg/kg,and vecuronium 0.10mg/kg propofol 1.5mg/kg were used for the induction of general anesthesia in group(T and EL). General anesthesia was maintained by propofol vecuronium and fentanil.ECG,MAP,SpO2,HR, PETCO2 and airway pressure were observed at the time before anesthesia (T1),before intubation (T2),1 min after intubation(T3),. the end of operation(T4),1 min after extubation(T5).Arterial blood samples was collectted at T1,T2,T3,T4 and T5 for determination of cortisol.We also record the amount of propofol,vecuronium and fentanil and observed some adverse events of anesthesia, such as pharyngolysis,move restless,nausea and vomitting.Results:1 There were no significant difference between the three groups in age,weight,blood pressure and heart rate at T1,PETO2,airway pressure at all time points(P>0.05). 2 The amount of propofol,fentanil and vecuronium of group ET and EL are significant lower than that in group T(P<0.05).3 There were no significant difference between the three groups in vomitting(P>0.05). The time of recovery and extubation in group T is significant longer than that in group ET and group EL(P<0.05).4 Cortisol in three groups were not significent difference at T1 and T2(P>0.05)..At T3,T4,T5 there were differences between group EL and group T,group ET(P<0.05). There were differences between group ET and group T at T5.Conclusion:1 Comparing with general anesthesia,epidural anesthesia combined with general anesthesia can make the hemodymanics of the patients undergoing radical mastectomy stable,reduce the amount of propofol and vecuronium and shorten the time of recovery and extubation.2 Comparing with general anesthesia and epidural anesthesia combined with general anesthesia, the anesthesia method of epidural anesthesia combined with LMA can make the hemodymanics of the patients undergoing radical mastectomy stabler, reduce the rate of pharyngolysis,move restless,nausea and vomitting and the level of Cortisol.So it is a good anesthesia method of radical mastectomy.