小儿氯胺酮麻醉前静脉注射长托宁与阿托品的对比研究

Comparison of penehyclidine hydrochloride and atropine used intravenously as premedication of ketamine anesthesia undergoing pediatric surgery

目的比较麻醉前静脉注射长托宁和阿托品对氯胺酮麻醉儿外科手术术前用药的临床效果。方法 60例ASAⅠ～Ⅱ级儿外科手术患儿随机分为Ⅰ组(长托宁组,n=30)和Ⅱ组(阿托品组n=30);氯胺酮静脉麻醉前10 min.静注研究药物0.01 mg/kg,记录HR、MAP、SpO_2的变化和唾液分泌量,术后恶心、呕吐不良反应发生率。结果长托宁组心率显著低于阿托品组,与基础值比较无显著差异。长托宁组唾液分泌物量及术后恶心、呕吐发生率显著低于阿托品组。结论长托宁有稳定心率和减少围术期唾液腺分泌的显著作用,可降低术后恶心呕吐发生率,更适合作为小儿氯胺酮麻醉前用药。

Objective To compare the effects of penehyelidine hydroehloride and atropine used intravenously as premedication of ketamine anesthesia in pediatric surgery. Methods 60 ASA grade Ⅰ - Ⅱ pediatric patients under general anesthesia were randomly allocated to one of two groups. Group Ⅰ （ n = 30） received penehyclidine hydroehloride 0. 01 mg/kg and group Ⅱ （n = 30） received atropine 0. 01 mg/kg. Penehyelidines hydroehloride or atropines were administered 10 minutes before induction of ketamine anesthesia. HR,MAP,SpO2 ,sputum secretion and the incidences of postoperative nausea and vomiting （PONV） were recorded. Results HR of penehyclidine hydroehloride group decreased evidently comparing with atropine group, there were no significant differences comparing with baseline. Sputum secretion and the incidences of PONV of penehyelidine hydroehloride group were obviously lower than that of atropine group. Conclusion Penehyelidine hydrochloride has a stability on HR ,decrease sputum secretion, reduce the incidences of PONV, it is a better choice of premediealion for children in ketamine anesthesia.