小儿眼外伤手术前应用长托宁的临床研究

Preaneanesthetic effect of penehyclidine hydrochloride in pediatric ocular trauma surgery with general anesthesia

目的探讨长托宁(盐酸戊乙奎醚)在小儿眼外伤术前给药的临床效果及其安全性。方法40例择期眼外伤手术患儿随机分成阿托品(A组)和长托宁(B组),每组20例,分别静脉注射阿托品和长托宁0.01 mg/kg,监测用药前、用药10 min、20 min4、0 min 4个时段心率、血压变化及给药前后面色、口干程度、鼻咽温度及镇静情况。结果两组给药后各时间段收缩压、舒张压与给药前比较其变化不明显(P>0.05)。A组用药10 min2、0 min的心率较注射前增快明显(P<0.05),而40 min时增快不明显(P>0.05);B组各时间段心率与注射前比较变化均不明显(P<0.05)。两组给药前后面红对比,A组明显,B组不明显。A组20 min内与给药前比较口干明显(P<0.05),40 min时口干不明显(P>0.05);B组各时间段口干均较明显(P<0.05)。A组在给药后10 min2、0 min体温升高明显(P<0.01),40 min时体温与给药前接近(P>0.05);B组给药后体温无明显变化(P>0.05)。A组给药后无镇静效果,B组给药后5例有镇静效果。结论长托宁对患儿心率、面色及体温的影响弱于阿托品并能起到一定的镇静作用,同时能更有效及持久地控制全麻期间气道分泌物,使小儿眼外伤麻醉的安全性得到进一步的保障。

Objective To observe the preanaesthetic effects and safety of penehyelidine hydrochloride （PH） for general anaesthesia in pedo-ocular trauma surgery. Methods 40 pedo-ocular trauma patients undergoing surgery with general anaesthesia were divided into two groups A and B randomly .Group A （n = 20） was given 0.01mg/kg atropine iv. While group B （ n = 20） was given 0.01mg/kg PH iv. Signed each patient＇s PR before induction of anaesthesia, after 10 min, 20 min and 40 min of administration of the drug and monitored the change in heart rate and blood pressure, facial color before and after the administration of the drug, degree of dry mouth, nasopharyngeal temperature （NTP）, degree of sedation and the upper respiratory tract secretion of the patients at these 4 time intervals. Results The SBP and DBP before and after drug administration didn＇ t have contrast change. （ P 〉 0.05） comparatively in either groups. In group A, the HR comparatively increased after 10 and 20 min of drug administration （ P 〈 0.05）, the HR change after 40 min of drug administration was not obvious （P 〉 0.05）. In group B, there was no obvious change in HR in the above given time intervals （ P 〈 0.05）. Red coloring of the face during the given time intervals was obvious in group A but not in group B. Dryness of mouth within 20 min of administration of drug in comparison with before administration was obvious in group A （P 〈0.05）, but not after 40 min of drug administration （P 〉 0.05 ）. There was obvious dryness of mouth in group B within the above given time （P 〈0.05）. In group B, there was no obvious change in body temperature at the above given time （P 〉 0.05）： there was obvious change in body temperature in group A at 10 min and 20 min of drug administration （ P 〈 0.01）, after 40 min of drug administration the body temperature was close to that of before the administration of drug. There was no sedative effect at given time intervals after drug administration in group A patients, but there were 5 types of sedative effects in group B after drug administration. Conclusions PH has low effect in HR, facial color and body temperature change than do atropine. PH has a little sedating effect and it＇s anticholinesterase effect is longer than that of atropine. PH can more effectively control the respiratory tract secretion of the patients under general anaesthesia which ensures the safety of general anaesthesia in pedo - ocular trauma surgery.