盐酸戊乙奎醚用于无痛胃镜麻醉前的用药研究

Study of Penehyclidine Hydrochloride Used as Preoperative Medication in Anodynia Gastroscope

目的:探讨盐酸戊乙奎醚用于无痛胃镜麻醉前用药的临床疗效、安全性、不良反应及其最适给药剂量。方法:静脉麻醉下行胃镜检查的120例患者,ASAⅠ～Ⅱ级,随机分为四组(每组30例)。于麻醉前10min分别静脉注射0.9%氯化钠注射液3 ml(A组),盐酸戊乙奎醚0.3mg(B组),0.5mg(C组),1.0mg(D组)。麻醉方法采用不插管的静脉全麻,静脉缓慢推注芬太尼0.75μg·kg^(-1)和异丙酚1.5mg·kg^(-1)。分别测量并记录给实验药物前后各时点的患者心率、平均动脉压、血氧饱和度及口干程度的视觉模拟评分(Visual Analogue Scale,VAS)。结果:A组麻醉后5min心率减慢较麻醉前有显著变化(P<0.05),B、C、D组患者给药后及麻醉后心率较基础值略减慢,给药后5min,10min平均动脉压较基础值略降低,均无显著变化(P>0.05)。B、C、D组患者在给药后5min,10min,术后5min,1h的VAS评分增高,B组(P<0.05),C、D组(P<0.01)与A组差异显著(P<0.01)。B、C组患者术后8h的VAS评分较基础值无明显差异,D组患者术后8h的VAS评分较基础值高(P<0.01)。结论:无痛胃镜麻醉前静脉注射盐酸戊乙奎醚可以有效减少患者的腺体分泌,便于呼吸道管理,并能稳定血流动力学,是一种安全、有效的门诊手术麻醉前用药,且0.5mg为最适给药剂量。

Objective：To evaluate the effect and safety of penehyrclidine hydrochloride when it was used preoperatively in anodynia gastroscope, and search for its optimization dose. Method：120 patients （ASA Ⅰ -Ⅱ class） were randomly divided into four groups （30 cases per group）. Group A were administered with 0.9% sodium chloride injection 3ml 10 minutes before anesthesia as Groups B, C and D were treated with penehyelidine hYdroehloride 0. 3rag, 0. 5mg and 1.0rag, respectively. HR, MAP, SPO2 and VAS were observed every time point after the medical administration. Result： The heart rate of Group A slowed down more significantly （P 〈 0.05 ） 5rain after anesthesia than before it, the heart rate of Groups B, C and D slowed down slightly after the administration or anesthesia, compared with the baseline. 10min mean arterial pressure was slightly lower than the baseline 5rain after the administration, and there were no significant changes （P 〉 0.05 ）. The VAS scores of 5min and l h post operation increased in Group B （P 〈 0. 05 ）, and Groups C and D （P 〈 0. 01 ） 5min and 10min after the administration. The VAS score was not significantly different compared with the baseline in Groups B and C, 8h post operation, but the VAS score of Group D was higher than the baseline （P 〈 0.01 ）. Conclusion： Penehyclidine hydrochloride administered preoperatively in anodynia gastroscope can reduce glandular organ secretion of patients effectively,which was conducive to the respiratory tract management. Also it can stabilize haemodynamics. Thus penehyclidine hydrochloride used as preoperative medication in outpatients is effective and safe. And 0.5mg is the optimization dose.