麻醉前应用阿托品对气道分泌物作用的临床研究

Effects of Atropine as premedication on secretion of respiratory glands

目的 评价麻醉前应用阿托品对呼吸道腺体分泌的作用。方法 30例ASAⅠ～Ⅱ级成人择期手术的病人随机分为 3组 ,A组术前 30min肌肉注射 0 .5mg阿托品和安定 10mg ,麻醉诱导为安定 0 .2mg/kg、芬太尼 2 .0 μg/kg、硫喷妥钠 5mg/kg及琥珀胆碱 2mg/kg ;B组与A组相同 ,术前不用阿托品 ;C组芬太尼的剂量为 4.0 μg/kg ,余均同B组。麻醉前用药后与麻醉诱导前记录病人的口腔干燥程度、与气管插管后 5～ 12 0min测定气道分泌物的量并记录血压和心率。结果 A组口干感与B及C组比较有显著性差异 (P <0 0 5 )。插管后气道内的分泌物的量 ,3组间无明显差异。气管插管后 30、6 0、12 0min分泌物的量均明显减少 ,以 6 0min最为明显 ,与插管后 5min比较有显著差异(P <0 0 5 )。

Objective To evaluate the effects of atropine as premedication on secretion of the respiratory glands.Methods Thirty adult patients (ASA grade Ⅰ to Ⅱ,scheduled for elective surgery under general anesthesia) were randomly divided into three groups.The patients in group A received atropine 0.5mg and diazepam 10mg as premedications and induction with diazepam 0.2mg/kg,fentanyl 2.0μg/kg,thiopental 5mg/kg and succinylcholine 100mg;In group B received diazepam 10mg as premedications and induction with drugs as group A;and in group C,also received diazepam as group B and induction with fentanyl 4μg/kg and the other drugs were just as group B.The dryness of the mouth was measured after premedication and before induction.The salivary secretions and systolic pressure,diastolic pressure,mean arterial blood pressure and heart rate were determined at 5,30,60 and 120min after tracheal intubation.Results All the patients in group A felt dryness after premedication.The degree of dryness in group A was higher than that of other groups( P <0.05).There were no significant differences in salivary secretion among the three groups,but the mean salivary secretion at 5min after intubation in group C was less than those of other groups( P >0.05).In all of the groups,the secretions at 30,60 and 120min after intubation decreased,but it decreased markedly at 60min compared with that at 5min after intubation( P <0.05).Except that heart rate raised after induction in the group A,B,no significant differences were seen among the three groups and in each group on hemodynamics during all the experimental periods.Conclusion It is concluded that routine premedication with atropine 0.5mg im.did not reduce the secretion of respiratory glands significantly.