2.2 Anesthesia application
The patient was admitted to the operating room for pulse oxygen
saturation, electrocardiogram and non-invasive blood pressure
monitoring. Following placement of a 20-gage intravenous line, all
patients received 14
mL•kg−1•h−1isotonic Lactic acid
Ringer’s solution intravenously (i.v.). Anesthesia induction: midazolam
(0.05 mg/kg body weight), sufentanil (0.5µg/kg), propofol (2 mg/kg) and
cis atracurium (0.15 mg/kg) were injected intravenously 3-5 minutes
after denitrification and oxygenation. A single-lumen endotracheal
catheter was used to complete ventilation. The ventilator ventilation
mode is volume control mode, and the patient’s end-expiratory carbon
dioxide level is maintained at 35-40 mmHg throughout the anesthesia
process.
During the anesthesia maintenance phase, 2% sevoflurane mixed with 60%
oxygen, remifentanil (0.5 µg/kg/min) and propofol (100 µg/kg/min) were
continuously pumped. Cisatracurium (0.15 mg/kg) was given every hour
during the operation. If the non-invasive blood pressure is more than
20% of the base value, remifentanil (0.1–1.0 µg/kg/min) is added
intravenously. If the blood pressure is more than 20% lower than the
baseline, give a rapid intravenous drip of saline 250mL or ephedrine 0.1
mg/kg. If the heart rate decreased to less than 50 bpm, atropine (0.5
mg/kg) was administered. At the end of the modified radical mastectomy
(MRM) procedure, neostigmine (0.05mg/kg) and atropine (0.02mg/kg) can
reverse the muscle relaxation effect of cisatracurium. After the
operation, the patient is transferred to the postoperative recovery
room, and the endotracheal tube can be extubated after being evaluated
by the anesthesiologist.