盐酸戊乙奎醚对腰硬联合麻醉下剖宫产产妇及胎儿的影响

Effect of penehyclidine hydrochloride on parturient and fetus in caesarean section under combined spinal and epidural anesthesia

目的观察盐酸戊乙奎醚对腰硬联合麻醉下剖宫产产妇及胎儿的影响。方法60例择期剖宫产手术患者随机分为两组：A组为盐酸戊乙奎醚组；B组为东莨菪碱组，每组30例。术前30min，A组肌肉注射盐酸戊乙奎醚0．5mg，B纽肌肉注射东莨菪碱0．5mg，记录用药前，麻醉前，麻醉后3、5、10min及术毕时的收缩压、舒张压、心率，同时观察术中寒战的发生率并记录胎儿娩出后1min和5min的Apgar评分。结果与用药前相比，A组心率麻醉前有所减慢，但差异无统计学意义，其他各时点无明显变化；B组心率在麻醉后3、5、10min明显增快，差异有统计学意义（P〈0．05）。组间比较，两组间HR差异有统计学意义。与用药前相比，两组麻醉后收缩压和舒张压均有所降低，在麻醉后3～10min明显，差异有统计学意义，但均在正常范围之内；纽间比较差异无统计学意义。两组间Apgar评分比较无统计学意义.与B组相比，A组寒战发生率较低，差异有统计学意义（P〈0．05）。结论盐酸戊乙奎醚可安全用于剖宫产产妇的术前用药，并显著降低寒战的发生率，对新生儿无不良影响，适合临床推广应用。

Objective To observe the effect of penehyclidine hydrochloride on parturient and fetus in caesarean section under combined spinal and epidural anesthesia. Methods Sixty patients scheduled for cesarean section were randomly divided into two groups with 30 patients in each group：the penehyclidine hydrochloride （group A） and the scopolamine （group B）. Then the SBP, DBP, HR were observed and recorded before anesthesia and postanesthetic time interval. And the incidence rate of shivering, neonatal Apgar score at 1 min and 5 min were recorded. Results Compared with before using drugs, the HR of group A was slower before anesthesia but there was no significant difference. There was no obvious change at the other time. The HR of group B was significant increased at 3 rain, 5 rain and 10 rain after anesthesia. The HR of tile two groups had statistical significance. The SBP and DBP of the two groups was lower after anesthesia, especially during 3 - 10 rain. But there was no significant difference between the two groups in BP and Apgar score. Compared with group B, the incidence rate of shivering was lower than that of group A. Conclusions Penehyclidine hydrochloride could be used in parturient safely as premedication, and can reduce the incidence rate of shivering significantly, but had no side effects on fetus, and deserves further clinical applications.