摘要
目的观察在拟行甲状腺部分切除术的患者中麻醉前静脉应用长托宁和东莨菪碱对循环系统的影响及并发症。方法选择40例ASAⅠ￣Ⅱ级需要行甲状腺次全切除术的患者,麻醉前随机静脉注射长托宁0.01mg/kg(Ⅰ组,n=20)和东莨菪碱0.01mg/kg(Ⅱ组,n=20),10min后,常规进行麻醉诱导和维持。结果Ⅰ组SBP、DBP、HR在给药后均有下降趋势(P<0.05),而Ⅱ组SBP、HR在给药后第3￣5min时明显升高(P<0.05),也显著高于Ⅰ组(P<0.01),10min后回落至正常水平(P<0.01)。Ⅰ组在给药后未发生心悸,而Ⅱ组中有8例(P<0.01),面红、口干的发生率也较少(P<0.05),而术中及术毕时的痰量却少于Ⅱ组(P<0.05)。结论长托宁为长效的腺体分泌抑制剂,可以在麻醉前静脉应用,特别适用于心率不宜增快的患者。
Objective To investigate the effects of penehyclidine hydrochloride and scopolamine intravenous before general anesthesia as premedication. Methods 40 hospitalized ASA Ⅰ～Ⅱ thyroidectomy patients were randomly divided into two groups： penehyclidine hydrochloride （Group Ⅰ, n=20） or scopolamine （Group Ⅱ, n=20） was infused intravenously as premedication under monitoring in operating room. 10 minutes later, they were induced and maintained routinely. Results In Group Ⅰ, blood pressure and heart rate declined after penehyclidine hydrochloride infused intravenously （P〈0.05）; on the contrary, in Group Ⅱ systolic blood pressure and heart rate increased at 3 and 5 minutes （P〈0.05） and dropped to normal degree （P〉0.05）. No palpitation happened in Group Ⅰ but 8 patients in Group Ⅱ （P〈0.01）. Flushing and dry mouth after infusion also happened less in Group Ⅰ （P〈0.05）. The volume of putum at the end of operation was less in Group Ⅰ than in Group Ⅱ （P〈0.05）. Conclusion As a kind of long-acting selective Ach-R blockers, penehyclidine hydrochlofide can safely be used as intravenous premedication especially for patients whose hteart rates can＇t increase.
关键词
长托宁
东莨菪碱
麻醉前用药
静脉注射
Penehyclidine Hydrochloride
Scopolamine
Premedication
Intravenous
