静脉注射盐酸戊乙奎醚和阿托品用于开胸手术术前用药的对比研究

Comparison of penehydidine hydrochloride and atropine used intravenously as premedication in patients undergoing thoracic surgery

目的比较盐酸戊乙奎醚、阿托品用于开胸手术前用药的临床效果。方法80例ASAⅠ～Ⅱ级胸科择期全麻手术患者随机分为Ⅰ组（盐酸戊乙奎醚组，n=40）和Ⅱ组（阿托品组，n=40），麻醉诱导前30min静脉注射盐酸戊乙奎醚或阿托品0．01mg／kg，记录SBP、DBP、HR、SpO2、口干程度及腺体分泌变化。结果两组患者注药前SBP、DBP、HR、Sp02无明显差异（P〉0．05）。Ⅰ组注药后第10min和15min SBP略下降，与注药前基础值相比差异具有统计学意义（P〈0．05）。Ⅱ组患者于注药后1min、5min、10min、15min HR明显高于基础值（P〈0．05），HR、SBP均明显高于Ⅰ组（P〈0．05）；两组VAS评分在注药后15min、30min时高于注药前（P〈0．05），两组间比较差异无统计学意义（P〉0．05）；插管后各时点、拔管及拔管后1h腺体分泌量两组有显著差异（P〈0．05及P〈0．01）。结论盐酸戊乙奎醚作为胸科术前用药效果满意，抑制腺体分泌作用效果确切，维持心血管功能稳定，是胸科患者理想的术前用药。

Objective To compare the effects of penehyclidine hydrochloride and atropine used intravenously as premedication in patients undergoing thoracic surgery. Methods 80 ASA grade Ⅰ～Ⅱ patients undergoing elective thoracic surgery under general anesthesia were randomly allocated to one of two groups. GroupⅠ （n = 40） received penehyelidine hydrochloride 0.01mg/kg and group Ⅱ（n = 40） received atropine 0.01 mg/kg. Penehyclidines hydrochloride or atropines were administered 30 minutes before induction of general anesthesia. SBP,DBP,HR,SpO2 , dryness degree of oral cavity and the secretion change of salivary gland were recorded. Results The baseline SBP,DBP,HR,SpO： were not significantly different among groups （P 〉 0. 05 ）. SBP was found significantly lower than baseline at 10 min and 15 rain in group I （P 〈 0.05 ）. HR was significantly higher than the baseline at 1 rain,5 rain,10 min,15 min after medication in group Ⅰ （P 〈0. 05）, HR and SBP were obviously higher than those of group Ⅰ（ P 〈 0. 05 ）. VAS score were significantly higher than the baseline at 15 min, 30 min after medication in both groups（ P 〈 0. 05 ） , no statistically significant difference was found between the two groups （ P 〉 0. 05 ）. The secretion of salivary gland were significantly different at each point after intubation ,extubation and extubation 1 h in both groups （P 〈0. 05＆ P 〈 0.01 ）. Conclusion Penehyclidine hydrochloride can be used before general anesthesia satisfactorily, Inhibite the secretion of salivary gland effectively, has stability on cardiovascular function, it is a better choice of premedication for patients undergoing thoracic surgery.