盐酸戊乙奎醚对比阿托品及东莨菪碱用作小儿气管内插管全麻前用药的临床观察

Clinical observation of penehyclidine hydrochloride compared with atropine and scopolamine as the preanesthetic medication for the infant

目的比较盐酸戊乙奎醚、阿托品及东莨菪碱用作气管内插管全麻患儿麻醉前常规肌注用药的效果，观察盐酸戊乙奎醚作为小儿麻醉前抗胆碱药的可行性。方法90例需行气管内插管全麻患儿根据麻醉前用药情况随机双肓分为盐酸戊乙奎醚组（phe组）、阿托品组（art组）和东莨菪碱组（sco组），各组30例，分别在麻醉开始前30rain于臀大肌注射盐酸戊乙奎醚（0．02mg／kg）、阿托品（0．01mg／kg）、东莨菪碱（0．006mg／kg），观察并记录给药前（To）、给药后15rain（T1）、给药后30rain（T2）、插管后（T3）及术毕拔管时（T4）患者的心率、体温、血压及呼吸道分泌物等指标。结果i组患儿年龄、性别、体重及手术时间均无显著性差异（P〉0．05）phe组术前注药后各时点的心率（HR）、体温（T）、血压（MBP）无明显改变（P〉0．05）art组、sco组患儿注药后心率均明显加快、体温升高（p〈0．05），与phe组比较有显著性差异（p〈0．05），血压无明显变化（P〉0．05）术毕拔管时，phe组患儿的分泌物较art组、seo组明显减少（p〈0．05）。结论盐酸戊乙奎醚具有显著的心率稳定作用及强大持久的腺体分泌抑制作用，作为麻醉前用药效果满意，优于阿托品和东莨菪碱，可安全用于小儿全身麻醉前给药。

Objective To compare the effects of penehyclidine hydrochlofide, atropine and scopolamine as the preanesthetic medication for the infant. Methods Ninety infants patients who would undergo general anesthesia with tracheal inmbation were divided randomly into three groups as follow： penehyclidine hydrochloride group （PHE group）, atropine group （ATR group） and scopolamine group （SCO group）, 30 patients in each group.Penehyclidine hydrochloride （0.02 mg/kg）, atropine （0.0l mg/kg） or scopolamine （0.006 mg/kg） was injected intramuscularly respectively 30 mimltes before operations. The changes of heart rate, temperature, blood pressure and the secretion of respirator）., tract were observed and recorded before medication, 15 minutes and 30 minutes after medication, after trachea cannula and after extubate. Results There were little difference among the three groups in gender, age, body weight and operation time. There were no significant changes in heart rate, temperature and blood pressure in group PHE after medication （P〉0.05）.Compared to PHE group, heart rate and temperature in ATR group and SCO group increased significantly （P〈0.05）, and blood pressure had no obvious change （P〉0.05）.The secretion of respiratory tract was decreased significantly in PHE group compared to those in ATR group and SCO group after operation （P〈0.05）. Conclusion Penehyclidine hydrochloride has no significant effect on heart rate and temperature and blood pressure, and it＇ s effect of inhibiting glandular secretion is longer than atropine and scopolamine. Therefore, Penehyclidine hydrochloride as the preanesthetic medication is safety for the infant.