盐酸戊乙奎醚改善ERCP术中的静脉麻醉效果

Effect of intravenous anesthesia in ERCP by Penehyclidine hydrochloride

目的观察盐酸戊乙奎醚改善ERCP术中的静脉麻醉效果。方法选择经ERCP行胆总管取石术患者120例,随机分为3组:A组仅口服2%利多卡因胶浆后直接行ERCP操作;B组口服2%利多卡因胶浆后10 min,予以丙泊酚1～2 mg/kg及芬太尼1～2μg/kg静注;C组口服2%利多卡因胶浆后10 min,予以盐酸戊乙奎醚0.02 mg/kg、丙泊酚1～2 mg/kg及芬太尼1～2μg/kg静注。B、C两组术中均持续静脉泵注丙泊酚20～25 mL/h及芬太尼2μg/h。每组各40例。进行ERCP操作过程标准评分及Ramsay镇静评分,统计术中口腔分泌物增多及上呼吸道梗阻的发生率。结果A、B两组口腔分泌物增多发生率高于C组(P<0.01);B组上呼吸道梗阻的发生率高于C组(P<0.01);ERCP操作过程评分:B、C两组操作过程评分均低于A组(P<0.01);Ramsay镇静评分:B、C两组>3分和≤3分者所占比例与A组比较差异有显著性(P<0.01)。结论盐酸戊乙奎醚可有效地改善ERCP术中的静脉麻醉效果。

[Objective] To observe the improved effect of intravenous anesthesia in ERCP by Penehyclidine hydrochloride. [Methods] 120 patients scheduled for calculus removed for common bile duct by ERCP were divided randomly and averagely into three groups with 40 cases each. Group A received local anesthesia by 2% Lidocaine hydroehloride mucilage PO before ERCP. Group B received Propfol 1-2 mg/kg and Fentanyl 1-2ug/kg intravenous anesthesia after local anesthesia 10 minutes later. Group C received Penehyclidine hydrochloride 0.02 mg/kg, Propfol 1-2 mg/kg and Fentanyl 1-2 ug/kg intravenous anesthesia after local anesthesia 10 minutes later. Group B and C received Propfol 20-25 mL/hour and Fentanyl 2 ug/hour by intravenous continuous infusion in operation. The score of the procedure and Ramsay score were used to evaluate the feasibility of this maneuver and the sedative effect, respectively. [Results] The rate of increased oral secretion in group A and B was significantly higher than that in group C （P 〈0.01）. The rate of the upper airway obstruction in group B was significantly higher than that in group C （P 〈0.01）. The score of the procedure in group B and C were significantly lower than those in group A （P 〈0.01）. The rate of Ramsay score of greater than 3 or smaller than or Equal to 3 in group B and C were significandy different than that in group A （P 〈0.01）. [Conclusion] Penehyelidine hydrochloride can effectively improve the effect of intravenous anesthesia in ERCP.