长托宁在小儿唇腭裂手术麻醉前用药的临床观察

Clinical observation of penehyclidine hydrochloride as the preanesthetic medication before operation for patients with cleft lip/palate

目的比较长托宁、阿托品及东莨菪碱术前肌注对唇腭裂手术全麻患者的效果。方法选择在气管插管全麻下行唇腭裂手术的120例患者为研究对象,将其随机分为长托宁组、阿托品组、东莨菪碱组,每组40例患者。3组患者术前分别肌注长托宁0.01mg/kg、阿托品0.01mg/kg、东莨菪碱0.006mg/kg,观察并记录给药前、给药后15min、给药后30min、插管后及术毕拔管时患者的心率、体温、血压及呼吸道分泌物等指标。结果长托宁组患者用药后心率、体温、血压无明显变化(P>0.05);阿托品组、东莨菪碱组患者用药后心率明显加快、体温升高(P<0.05),血压无明显变化(P>0.05)。术毕拔管时,长托宁组患者的分泌物较阿托品组、东莨菪碱组明显减少(P<0.05)。结论长托宁作为小儿唇腭裂手术前用药对心率、体温、血压无明显影响,对呼吸道腺体分泌有持久的抑制作用,优于阿托品与东莨菪碱。

Objective To compare the effects of penehyelidine hydroehloride, atropine and scopolamine as the preanesthetic medication before operation for patient with cleft lip/palate （CL/P） who would undergo general anesthesia. Methods 120 CL/P patients who would undergo general anesthesia with tracheal intubation as research objects were chosen. The patients were divided into three groups randomly, group of penehyclidine hydrochloride （group PH）, group of atropine （group ATR） and group of scopolamine （group SCO）, 40 patients in each group. Penehyclidine hydrochloride（0.01 mg/kg）, atropine（0.01 mg/kg） or scopolamine（0.006 mg/kg） was given respectively to the patients. The changes of heart rate, temperature, blood pressure and the secretion of respiratory tract were observed before medication, 15 minutes and 30 minutes after medication, after trachea eannula and after operation. Results There were no significant changes in heart rate, temperature and blood pressure in group PH after medication （P〉0.05）. The heart rate and temperature in group ATR and group SCO increased significantly after medication （P〈0.05）, however, the blood pressure had no obvious change （P〉0.05）. The secretion of respiratory tract was decreased significantly in group PH comparing to group ATR and group SCO when the operation was over （P〈 0.05）. Conclusion Penehyclidine hydrochloride has no significant effect on heart rate, temperature and blood pres- sure to the patients, and it＇s effect of secretion inhibition is longer and it is better than atropine and scopolamine.