盐酸戊乙奎醚对老年全身麻醉患者应用维库溴铵肌肉松弛作用的影响

Effects of penehyclidine hydrochioride as premedication on neuromuscular blockade of vecuronium in elderly patients

目的观察老年患者术前应用盐酸戊乙奎醚后，对非去极化肌肉松弛药维库溴铵的肌肉松弛作用的影响。方法选择90例无肝肾功能异常和神经及肌肉代谢性疾病老年需全麻手术患者，完全随机分为阿托品0．5mg组（A组）、盐酸戊乙奎醚0．5mg组（B组）和盐酸戊乙奎醚1．0mg组（C组）。插管前30min按分组术前用药，记录肌肉松弛药的起效时间（T1抑制至0的时间），停止输注维库溴铵T1恢复到25％、75％和90％的时间，恢复指数（T1从参照值的25％恢复至75％）。结果C组和A、B组比较，维库溴铵起效时间显著缩短[C组（2．8±0．6）min，A组（4．5±0．7）min，B组（4．6±0．5）min]，差异有统计学意义（P〈0．05）；3组患者T1的25％和75％恢复时间以及恢复指数差异无统计学意义（P〉0．05），90％恢复时间C组较A和B组有所延长，但差异无统计学意义（P〉0．05）。结论盐酸戊乙奎醚作为老年全身麻醉患者的术前用药可以明显缩短维库溴铵插管时间，且不延长拔管时间。

Objective To observe the effects of Penehyclidine hydrochloride as premedication on neuromus- cular blockade of vecuronium in Elderly Patients. Methods Ninety elderly patients without complications of main organs were randomly divided into 3 groups ： atropine （ A ） group, Penehyclidine 0.5 mg（ B ） group and Penehyclidine 1.0 mg （C） group. Atropine （0.5 mg） and Penehyclidine （0.5 and 1.0mg） were administered intramuscularly 30 minutes before operations. Neuromuscular block was monitored using accelograph. The onset time and maximum depression of T1 were recorded. The time of T1 returning to 25% ,75% ,90% were recorded. The recovery index was also calculated. Results The onset time of vecuronium was shorter in C group than that in A and B groups. There was no difference of 25% and 75% recovery time among three groups. 90% recovery time was longer in C group than that in A and B groups without statistical difference. Conclusion Penehyclidine hydrochloride is a good premeditation choice for elderly patients under general anesthesia induced by vecuronium but slightly prolongs 90% recovery time.