无阿片麻醉方案对乳腺癌改良根治术后恢复质量影响OA

Objective To investigate the effect of opioid-free anesthesia(OFA)regimen on the quality of postoperative re-covery in patients undergoing modified radical mastectomy for breast cancer.Methods The patients undergoing elective unilate-ral modified radical mastectomy were enrolled as subjects,and they were divided into OFA group and standard anesthesia group(SA group)using the block randomization method,with 45 patients in each group.The primary outcome measure was 40-Item Quality of Recovery Scale(QoR-40)score at 24 h after surgery,and secondary outcome measures included mean arterial pressure(MAP)and heart rate(HR)at the following time points of immediately after entering the operating room(T0),1 min after induc-tion of anesthesia(T1),1 min after intubation(T2),and 1 min after skin incision(T3),the number of times of rescue analgesic administration,time to extubation,the length of stay in the post-anesthesia care unit(PACU),Numeric Rating Scale pain score at 24 h after surgery,and safety outcome measures.Results Among the 90 patients,there were 39 patients in the OFA group and 39 in the SA group.Compared with the SA group,the OFA group had a significantly higher QoR-40 score at 24 h after surgery(Z=4.510,P＜0.05),significantly higher MAP and HR at T1-T3(t=2.822-5.176,Z=6.387-6.913,P＜0.05),a significantly longer length of stay in the PACU(Z=3.508,P＜0.05),and significantly lower incidence rates of postoperative nausea,vomiting,and muscle soreness(x2=6.154-11.791,P＜0.05).For the OFA group,HR at T2 and T3 was significantly higher than that at T0(Z=4.298,5.525;P＜0.05);for the SA group,MAP at T1 and T2 was significantly lower than that at T0(t=3.014,6.459;P＜0.05),and HR at T1 was significantly lower than that at T0(Z=7.411,P＜0.05).Conclusion OFA can improve the quality of postoperative recovery in patients undergoing radical mastectomy.