长托宁在老年ERCP麻醉前用药的临床观察

Clinical Observation of Penehyclidine Hdrochloride in Pemedication of ERCP in Ederly Ptients

目的:探讨长托宁作为老年患者ERCP麻醉前用药的可行性,临床效果及安全性。方法:选取2009年5月-2013年2月本院90例在静脉麻醉下行ERCP手术老年患者,随机数字表法分为三组,长托宁组30例,阿托品组30例,生理盐水组30例,三组分别以长托宁,阿托品,生理盐水作为麻醉前用药。比较三组患者在麻醉给药后不同时间点SBP、DBP、HR以及唾液分泌量的变化,并比较三组患者在术中术后出现的不良反应情况。结果:三组患者血压变化均平稳,长托宁组患者心率变化较阿托品组平稳,和生理盐水组比较变化无统计学差异,长托宁组患者唾液分泌量明显少于阿托品及生理盐水组。阿托品组患者在给药前后心率变化差异有统计学意义(P<0.05)。结论:长托宁在应用于老年ERCP术前麻醉时,对老年患者的循环血流动力学影响小,在抗胆碱作用时比阿托品效果更持续,并能够有效的控制围术期间呼吸道分泌物,是一种更为理想的老年患者麻醉前用药。

Objective：To investigate feasibility,efficacy and safety of penehyclidine hydrochloride used as premedication of ERCP in elderly patients.Method：90 elderly patients undergone ERCP surgery under intravenous anesthesia from May 2009 to February 2013 in our hospital were randomly divided into three groups：penehyclidine hydrochloride group（30 cases）,atropine group（30 cases） and physiological saline group（30 cases）.Three groups respectively used penehyclidine hydrochloride,atropine and physiological saline as premedication.Changes of SBP,DBP,HR and saliva secretion volume of the three groups at different time points after premedications were compared,at the same time intraoperative and postoperative adverse reactions in three groups were compared.Result：Blood pressures of the three groups changed smoothly,and changes of heart rates of patients in the penehyclidine hydrochloride group was smoother than that of the atropine group,and there was no significant difference when that in the penehyclidine hydrochloride group compared with that in the physiological saline group.Saliva secretion volumes in penehyclidine hydrochloride group were significantly less than that in the atropine group and the physiological saline group.Changes of heart rates of patients in the atropine group before and after dosing had significant difference.Conclusion：Penehyclidine hydrochloride has a small circulating hemodynamic effect in elderly patients when it is used as premedication in geriatric ERCP,and anti-cholinergie effect of penehyclidine hydrochloride is more sustainable than that of atropine,and penehyclidine can effectively control respiratory secretions during the perioperation,and it is a more ideal premedication of elderly patients.