盐酸戊乙奎醚在小儿全麻后肌松拮抗中的应用

Application of penehyclidine hydrochloride in antagonist of muscle relaxant after children general anethesia

目的探讨盐酸戊乙奎醚在小儿全身麻醉（全麻）后肌松拮抗中的优势及安全性。方法将年龄5~7岁患儿80例,性别不限,随机分为A、B、C、D 4组。在全麻结束后,4个成串刺激（TOF）恢复75%时：A组患儿给予阿托品15μg/kg、新斯的明40μg/kg;B组患儿给予盐酸戊乙奎醚20μg/kg;C组患儿给予新斯的明40μg/kg;D组患儿给予盐酸戊乙奎醚20μg/kg、新斯的明40μg/kg。观察患儿心率,心率变异指数（HRI）,体温,收缩压（SBP）,拔管时间。结果 A组患儿心率明显增加,HRI增加,呼吸浅快,体温升高,烦躁;B组患儿心率增加不明显,呼吸恢复慢,拔管时间延长;C组患儿心率明显减慢,需用阿托品提高心率;D组患儿心率稍减慢,HRI小,呼吸恢复快而平稳,体温正常,患儿安静,与A组比较拔管时间无显著差异。结论盐酸戊乙奎醚复合新斯的明在小儿全麻后残余肌松拮抗中应用是安全有效的,且具有镇静的优势。

Objective To investigate the advantage and safety of penehyclidine hydrochloride combined with neostigmine as the antagonist of muscle relaxant in children general anethesia.Methods 80 children with 5-7 years old underggene general anthesia were randomly divided into 4 groups：group A,group B,group C and group D.Children in group A were administrated with atropine 15 μg/kg ＋neostigmine 40 μg/kg,children in group B were administrated with neostigmine 40 μg/kg,children in group C were administrated with neostigmine 40 μg/kg,children in group D were administrated with penehyclidine hydrochloride 20 μg/kg ＋ neostigmine 40 μg/kg after general anethesia.Heart rate,variability index of heart rate,body temperaturea and duration of extubation were recorded.Results Heart rate,variability index of heart rate and body temperature increased obviously in group A after administrated with atropine 15 μg/kg ＋neostigmine 40 μg/kg,and children were agitated,needed to stay with parents.Heart rate was decreased lightly,variability index of heart rate and body temperature increased more or less in group D after administrated with penehyclidine hyerochlcride 20 μg/kg ＋neostigmine 40 μg/kg,and children were quiet.The duration of excubation in group C was not different compared with group A,therefore the duration of excubation in group B was longer significantly compared with group A and C.Conclusion Penehyclidine hydrochloride and neostigmine is safe and effective as antagonist to muscle relaxant in children general anethesia and children are quiet and cooperated with doctor with sedation of penehyclidine hydrochloride.