盐酸戊乙奎醚对全麻老年患者潮气量和肺顺应性的影响

Effect of penehyclidine on tidal volume and pulmonary compliance in elder patients during general anesthesia

目的研究盐酸戊乙奎醚对全麻下老年患者的潮气量(VT)和肺顺应性(CL)的影响。方法4 0例ASAⅠ或Ⅱ级拟行气管插管全身麻醉的择期手术患者随机均分为老年组(6 5～8 5岁)和成年组(3 0～5 5岁),诱导用咪唑安定0.0 3 mg/kg、丙泊酚2 mg/kg、芬太尼3μg/kg、维库溴铵0.1 mg/kg静注;压力控制机械通气,维持PETCO2在正常范围;丙泊酚、维库溴铵持续输注维持麻醉。诱导后2 0 min,静脉给予盐酸戊乙奎醚0.0 2 mg/kg。记录给盐酸戊乙奎醚前后HR、MAP、SpO2、PETCO2、VT、CL变化,并行血气分析。结果两组HR、MAP差异无统计学意义。老年组VT、CL在给盐酸戊乙奎醚前下降明显,且明显低于成年组(P<0.0 5),给药后有明显回升。结论对于老年患者,盐酸戊乙奎醚可以明显扩张支气管,改善机械通气所致的VT和CL下降,且对血流动力学无明显影响。

Objective To investigate the effect of penehyclidine on tidal volume（VT） and lung compliance（CL） in eider patients during general anesthesia. Methods Forty ASA Ⅰ or Ⅱ patients scheduled for selective operation under general anesthesia were equally divided into 2 groups of adult group（30--55 years old） and old group（65--85 years old）. Anesthesia was induced with midazolam 0. 03 mg/kg, propofol 2 mg/kg, fentanyl 3 μg/kg, vecuronium 0.1 mg/kg. Anesthesia was maintained with propofol and vecuronium continuous intravenous infusion. Pressure controlled ventilation was performed after tracheal intubation. PET CO2 was maintained at normal range. Penehyclidine 0. 02 mg/kg was administered IV. in two groups at 20 min after tracheal intubation. HR, MAP, SpO2, PETCO2 ,VT and CI. were monitored continuously. Arterial blood gas analysis was performed as well. Results There were no significant differences in HR and MAP between the two groups. Compared with those in adult group, VT and CL were significantly decreased before penehyclidine injection（P〈0. 05） and increased then after in old group. Conclusion During general anesthesia elder patients, intravenous injection of penehyclidine can dilate the bronchus and increase CL without influence on hemodynamics.