盐酸戊乙奎醚作为全麻术前用药的安全性研究

Study of premedication of penehyclidine hydrochloride before general anesthesia

目的对比研究盐酸戊乙奎醚与阿托品作为全麻术前用药的安全性。方法40例拟在全麻下行择期手术的患者,美国麻醉医师(ASA)分级Ⅰ～Ⅱ级,随机均分为4组,Ⅰ、Ⅱ、Ⅲ组分别肌内注射盐酸戊乙奎醚0．005、0．010和0．014 mg／kg,Ⅳ组肌内注射阿托品0．01 mg／kg。分别记录患者进入手术室后的基础口干程度视觉模拟评分和基础唾液分泌量,以及在注射药物30 min后的相应变化。记录各组患者注射药物后30、45、60和120 min的心率、平均动脉压、脉搏血氧饱和度和心电图的变化。结果肌内注射0.005和0．010 mg／kg盐酸戊乙奎醚后30 min唾液的分泌量无明显变化(P值均>0．05),而肌内注射0．014 mg／kg盐酸戊乙奎醚能明显抑制唾液分泌(P<0．01),平均抑制程度为56％。Ⅳ组注射阿托品后30 min的心率明显增快(P<0．05),Ⅰ、Ⅱ、Ⅲ组的心率无明显变化(P值均>0．05)。结论盐酸戊乙奎醚可以替代阿托品作为全麻术前用药,且特别适用于需要避免心动过速的患者。

Objective Penehyclidine hydrochloride is a novel anticholinerigic drug, which has the effect not only on the peripheral but also on the central cholinerigic receptors. The aim of this study is to compare penehyclidine hydrochloride with atropine using as a premedieation before general anesthesia. Methods Forty patients（ASA Ⅰ -Ⅱ ） scheduled for general anesthesia were ramdomly allocated into four groups, patients in group Ⅰ , Ⅱ , and Ⅲ were adminlstratered individually with penehyclidine hydrochloride intramuscularly at a dosage of 0. 005, 0. 010 and 0. 014 mg/kg, respectively. Patients in group IV were administratered atropine 0.01 mg/kg in the same way. Thirst-visual analogue scale and salivary secretion were recorded when the patients entered the operating room and 30 min after penehyclidine hydrochloride or atropine. HR, MBP, SpO2, and ECG were also recorded at the time points of 30, 45, 60 and 120 min after administration. Results There was no significant effect of penehyclidine hydrochloride（0. 005 or 0. 010 mg/kg） on salivary secretion, but it could inhibit salivary secretion as much as 56% at the dosage of 0. 014 mg/kg, simultaneously with no effect on HR in various dosages, however, atropine increased HR significantly. Conclusion Penehyclidine hydrochloride can substitute atropine as a premedication before general anesthesia, which is more appropriate for patients who wish to avoid tackycardia.