长托宁对耳鼻喉科手术患者血压、心率、呼吸及腺体分泌的临床观察

Effect of penehyclidine hydrochloride on blood pressure,heart rate,respiration,and gland secretion of patients undergoing ear,nose,and throat surgery

目的:研究盐酸戊乙奎醚(长托宁)用于耳鼻喉科手术时对血压(BP)、心率(HR)、呼吸及唾液分泌的影响,并选择最佳用药剂量。方法:80例行耳鼻喉科手术的患者,随机分为4组,术前10min分别静注生理盐水(A组)、阿托品0.01mg/kg(B组)、长托宁0.005mg/kg(C1组)、长托宁0.01mg/kg(C2组)。分别测量并记录注药前后BP、HR、脉搏氧饱和度(SpO2)及患者口干程度的视觉模拟评分(VAS)和术后气管及口腔内分泌物量。结果:C1组和C2组注药后HR较基础值显著降低(P<0.05);B组注药后HR显著增快(P<0.05);注药后10min和拔管后C1组的VAS值比B组低(P<0.05),术后1hC2组的VAS比B组高(P<0.05)。结论:术前静注长托宁0.01mg/kg,可有效减少患者术中及术后口腔、呼吸道分泌物,且不增加HR。

Objective： To observe the effect of penehyclidine hydrochloride on blood pressure （BP）, heart rate （HR）, oxyhemoglobin saturation by pulse oximetry （SpO2） , and gland secretion in patients undergoing ear, nose, and throat surgery. Methods： Eighty patients undergoing ear, nose, and throat surgery were randomly divided into 4 groups, in which the patients were intravenously injec- ted with 2 ml of normal saline （group A）, 0.01mg/kg of atropine （group B）, 0. 005 mg/kg of penehyclidine hydrochloride（group C1 ）, and 0.01 mg/kg of penehyclidine hydrochloride （group C2） 10 minutes before the induction of anesthesia, respectively. In all patients, BP, HR, SpO2, visual analog scale （VAS） scores for thirst, and the tracheal and salivary secretion volume were determined both before and after the injection. Results： Compared with the baseline, HR in groups C1 and C2 were significantly lower. In group B, HR significantly increased after the injection of atropine. The VAS scores for thirst in group C1 was significantly lower than those in group B 10 minutes after injection and after extubation, and the VAS scores for thirst in group C2 was significantly higher than those in group B 1 hour after operation. Conclusion： Penehyclidine hydrochloride （0.01 mg/kg） injected intravenously before operation can decrease salivary secretion effectively without increasing HR.