Effect Of Low Opioid Anesthesia On Postoperative Recovery Quality Of Patients Undergoing Modified Radical Mastectomy

Objective Breast cancer has become the largest cancer in the world.In China,the incidence of breast cancer is the highest among Chinese women.Modified radical mastectomy is a common surgical method for the treatment of breast cancer.Breast cancer surgery is often accompanied by obvious pain,lack of pain control will often lead to prolonged hospitalization,slow down postoperative recovery and decreased patient satisfaction and other consequences.Opioids can effectively reduce pain from the body,viscera and nerves,and are ideal for reducing intraoperative stress response and postoperative pain treatment.However,the widespread use of opioids has also exposed its limitations,such as nausea and vomiting,respiratory depression,hyperalgesia and opioid tolerance.The purpose of this study was to explore the effect of low opioid anesthesia on the recovery quality of patients undergoing modified radical mastectomy.Methods A total of 146 patients undergoing modified radical mastectomy in the Department of Chaohu Hospital affiliated to Anhui Medical University from May 2020 to October 2021 were randomly divided into two groups: routine anesthesia group（group C,n=64）and low opioid anesthesia group（group L,n=64）.Routine anesthesia and low opioid anesthesia were used to manage perioperative anesthesia.Basic patient information and Apfel PONV risk score were recorded.The main outcome measures were perioperative opioid dosage and Qo R-40 score.Secondary observation indexes:hemodynamic index and BIS value at each time point,postoperative 30 min RASS sedation score,postoperative NRS score at each time point,postoperative first self-controlled administration time,sleep quality score on the night of operation,time of patients out of resuscitation room,time out of bed after operation,days of hospitalization,incidence of postoperative adverse reactions.Results 1.There was no significant difference in age,BMI,ASA grade and Apfel PONV risk score between the two groups（P>0.05）.2.The dosage of sufentanil during and after operation in group L was lower than that in group C（P<0.05）;The time of the first postoperative self-controlled administration in group L was later than that in group C（P<0.05）;The postoperative Qo R-40 score,sleep quality score on the night of operation and 30 min RASS sedation score in group L were higher than those in group C（P<0.05）;The NRS scores at 0.5h,2h and 6h in group L were lower than those in group C（P<0.05）;The length of hospital stay and the incidence of postoperative adverse reactions in group L were lower than those in group C（P<0.05）.3.There was no significant difference in other observation indexes between the two groups（P>0.05）.Conclusion 1.Low opioid anesthesia can significantly reduce the perioperative dosage of opioids.2.The analgesic effect of low opioid anesthesia on getting up early after operation is stronger than that of conventional anesthesia.3.The patients with low opioid anesthesia had high degree of postoperative sedation,good sleep quality on the night of operation,high quality of postoperative recovery,low incidence of postoperative adverse reactions and quick discharge time.