Objective To investigate hemodynamic effect of different concentrations of Ropivacaine combined with laryngeal mask airway (LMA) for spinal block on patients undergoing radical mastectomy. Methods A total of 60 breast cancer patients undergoing selective operation during June 2012 and December 2013 were randomly divided into group Ⅰ (n = 20, 0. 1% Ropivacaine concentration), group Ⅱ (n = 20, 0. 2% Ropivacaine concentration) and groupⅢ (n = 20, 0. 3% Ropivacaine concentration). T4 - 5 epidural anesthesia was performed in three groups, and then LMA was given. Changes of blood pressure, heart rate (HR) and cardiac output (CO) at 5 min before anesthesia (T0 ), 15th min after Ropivacaine infused spinal canals (T1 ), at the moment of cutting fur skin (T2 ) and the moment of extracting LMA (T3 ) were observed, and incidence rate of hypoxemia at 5th min after extracting lMA was also observed. Results Levels of blood pressure and HR on T2 were significantly higher than those on T0 in groupⅠ, and levels of blood pressure and HR on T1 and T3 were significantly lower than those on T0 in group Ⅲ (P < 0. 05). In group Ⅱ, levels of blood pressure and HR on T2 were significantly lower than those in group Ⅰ, and the levels on T1 and T3 were significantly higher than those in group Ⅲ (P < 0. 05); the differences in CO levels on T1 , T2 and T3 were not statistically significant compared with those on T0 among the three groups (P > 0. 05), but levels of CO on T1 and T3 in group Ⅰ and Ⅱ were significantly higher than those in group Ⅲ (P < 0. 05). Postoperative incidence rate of hypoxemia in group Ⅰ and Ⅱwere significantly lower than those in group Ⅲ (P < 0. 05). Conclusion Epidural anesthesia in superior position with the concentration of 0. 2% Ropivacaine combined with laryngeal mask airway may effectively retain hemodynamic stabili-zation with lower incidence rate of hypoxemia during radical mastectomy.%目的：探讨不同浓度罗哌卡因高位椎管内阻滞联合喉罩通气对乳腺癌根治术患者血流动力学的影响。方法选择2012年6月—2013年12月择期乳腺癌根治术60例,分为Ⅰ、Ⅱ、Ⅲ组,每组20例。Ⅰ、Ⅱ、Ⅲ组罗哌卡因浓度分别为0.1%、0.2%、0.3%。3组分别行 T4~5硬膜外麻醉,喉罩通气。观察3组在麻醉前5 min(T0),罗哌卡因注入椎管后15 min(T1),切皮即刻(T2),拔出喉罩即刻(T3)时的血压、心率和心输出量(CO)变化,以及拔出喉罩5 min后低氧血症的发生情况。结果Ⅰ组 T2时点血压、心率高于 T0,Ⅲ组 T1、T3时点血压、心率低于 T0(P <0．05)；Ⅱ组在 T2时点血压、心率低于Ⅰ组,在 T1、T3时点血压、心率高于Ⅲ组(P <0．05)；3组 T1~3时点 CO 与 T0比较差异无统计学意义(P >0．05),但Ⅰ组和Ⅱ组在 T1、T3时点 CO 高于Ⅲ组(P <0．05)。Ⅰ组和Ⅱ组术后低氧血症发生率低于Ⅲ组(P <0．05)。结论0.2%罗哌卡因高位硬膜外阻滞联合喉罩通气可有效维持围术期乳腺癌根治术患者血流动力学的稳定,术后低氧血症发生率低。
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