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Objective To explore the efficacy and the safety of oxycodone hydrochloride injection in the induction and maintenance of general anesthesia in breast cancer patients.Methods A total of 200 female patients,aged 25-65 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective breast-conservative surgery,were randomly divided into 2 groups (n=100 each): oxycodone hydrochloride group (group O) and sufentanil group (group S).Oxycodone 0.2 mg/kg (group O) or sufentanil 0.2 μg/kg (group S) with propofol 2 mg/kg and cisatracurium 0.15 mg/kg were administered intravenously for general anesthesia induction.Propofol target-controlled infusion combined with remifentanil were used for maintenance of general anesthesia during the operation.Anesthesia time,awake time,extubation time,total consumption of propofol and remifentanil were recorded.The adverse events and VAS scores after surgery were observed.Results There was no significant difference between groups in anesthesia time,awake time,extubation time,consumption of propofol and remifentanil.Compared with group S,group O had lower VAS score at 2 h after surgery (P<0.05),but with no significant difference at other time points.There was no significant difference at the incidence of moderate pain between group.The incidence of dizziness was 18% in both groups.The incidence of nausea was 11 (11%) in group S and 9 (9%) in group O with no significant difference.Conclusion Taken together,oxycodone hydrochloride used for general anesthesia in breast cancer patient is practicable.
ABSTRACT
Objective To evaluate the safety and effective dose of oxycodone hydrochloride in-jection for postoperative analgesia in breast cancer patients undergoing modified radical mastectomy under general anesthesia in a prospective,randomized controlled clinical trial.Methods One hundred fe-male patients at ASAⅠ or Ⅱ,aged 29-69 years,BMI< 30 kg/m2 ,scheduled for elective modified radical mastectomy under general anesthesia,were randomly divided into two groups (n =50):low dose oxycodone hydrochloride injection group (group OL),and high dose oxycodone hydrochloride injection group (group OH).Oxycodone 0.03 mg/kg (group OL)and 0.09 mg/kg (group OH)was intravenous injected 30 mi-nutes before the end of the operation,respectively.Anesthetics usage was terminated when skin was sutured.Pain at rest and during movement was assessed using VAS score at 5 min,0.5,2,4,8,12 and 24 h after extubation of laryngeal mask.Total consumption of analgesic for rescue analgesia in the ward and the adverse events were recorded.Results Compared with group OL,group OH had lower VAS scores,There were significant differences in the VAS scores between groups at 8 and 12 h after surgery (P <0.05).No serious adverse event occurred in each group postoperatively.The most common adverse event was nausea, followed by vomiting and dizziness.There was no significant difference in the incidence of adverse event be-tween the two groups.Conclusion 0.09 mg/kg oxycodone hydrochloride injection is safe and effective in re-ducing pain after breast cancer radical operation.
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Objective To investigate the influence of neoadjuvant chemotherapy on the occurrence of postoperative nausea and vomiting ( PONV) after radical mastectomy. Methods A total of 286 breast cancer patients, aged 18-60 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective modified radical mastectomy under general anesthesia in our hospital, were divided into either non?chemotherapy group ( n=106 ) or neoadjuvent chemotherapy group ( n=180 ) . General anesthesia was induced with iv propofol 2 mg∕kg, rocuronium 0. 6 mg∕kg and sufentanil 0. 2 μg∕kg. The patients were endotracheally intubated. The concentration of sevoflurane inhaled was adjusted according to the value of bispectral index, and bispectral index value was maintain at 40-50. Ondansetron 8 mg and flurbiprofen axetil 100 mg were injected intravenously at 30 min before the end of surgery. If vomiting occurred for 2 consecutive times, and continuous nausea and vomiting appeared from the time point after extubation to 24 h after surgery, and the patients required treatment, rescue medication was used. The occurrence and severity of PONVwithin 24 h after surgery and requirement for rescue medication were recorded. Results Compared with non?chemotherapy group, the incidence of PONV within 24 h after surgery and requirement for rescue medication were significantly increased, and the severity of PONV was aggravated in neoadjuvent chemotherapy group (P<0.05). Conclusion Neoadjuvant chemotherapy before surgery can increase the risk and severity of PONV after modified radical mastectomy.
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Objective To investigate the effect of neoadjuvant chemotherapy on EC50 of propofol given by TCI which produces loss of consciousness (LOC) in breast cancer patients.Methods Ninety ASA Ⅰ or Ⅱ breast cancer patients aged 30-60 yr scheduled for elective surgery were allocated into 3 groups according to the chemotherapy the patients received (n=30 each):group Ⅰ control (group C) received no chemotherapy;group Ⅱ taxol and group Ⅲ adriamycine+cyclophosphamide+5-Fu.The patients were unpremedicated.The EC50 of propofol given by TCI was determined by up-and-down technique.The initial effect-site concentration (Ce) of propofol was 2.07μg/ml and the ratio between the 2 successive Ce was 1.09.Loss of response to verbal command and eyelash stimulation was used as sighs of LOC.The EC50 of propofol was calculated.Results The EC50 of propofol causing LOC was significantly lower in group Ⅱ and Ⅲ than in control group.There was no significant difference in the EC50 of propofol which produces LOC between group Ⅱ and Ⅲ.Conclusion The EC50 of propofol causing LOC in breast cancerpatients is decreased by adjuvant chemotherapy.