盐酸戊乙奎醚用于老年患者胸腹手术麻醉的安全性评估

Evaluation on Safety of Penehyclidine Hydrochloride for Anesthesia in Elderly Patients Undergoing Thoracic and Abdominal Surgery

目的:研究老年胸腹手术患者术前应用不同剂量盐酸戊乙奎醚的麻醉效果及安全性。方法:将我院2018年1月~2021年1月收治的135例老年胸腹手术患者随机分为对照组、小剂量盐酸戊乙奎醚组、大剂量盐酸戊乙奎醚组,每组各45例,观察三组患者围麻醉期相关指标、血流动力学指标、神经功能指标、认知功能。结果:三组睁眼时间、拔管时间均无统计学差异(均P>0.05),大剂量盐酸戊乙奎醚组躁动发生率明显高于对照组及小剂量盐酸戊乙奎醚组(均P<0.05)。小剂量组、大剂量盐酸戊乙奎醚组患者血流动力学指标、神经功能指标、认知功能均明显优于对照组(均P<0.05)。结论:老年胸腹手术患者术前应用小剂量盐酸戊乙奎醚可有效减少腺体分泌,有利于维持血流动力学稳定,保护术后认知功能。

Objective:To explore the anesthetic effects and safety of penehyclidine hydrochloride at different dose in elderly patients undergoing thoracic and abdominal surgery.Methods:A total of 135 elderly patients with thoracic and abdominal surgery in our hospital between January 2018 and January 2021 were randomly divided into the control group,the low-dose of penehyclidine hydrochloride group and the high-dose of penehyclidine hydrochloride group,with 45 cases in each group.The perianaesthesia related indicators,hemodynamic indicators,neurological function and cognitive function were compared among these three groups.Results:There were no significant differences in the eye-opening time and extubation time among these three groups(both P>0.05).The incidence of agitation was significantly higher in the high-dose of penehyclidine hydrochloride group than that in the control group and the low-dose of penehyclidine hydrochloride group(both P <0.05).The hemodynamic indicators,neurological function and cognitive function in the low-dose and the high-dose of penehyclidine hydrochloride group were significantly better than those in the control group(all P<0.05).Conclusion:Application of preoperative penehyclidine hydrochloride at low-dose in elderly patients undergoing thoracic and abdominal surgery can effectively reduce gland secretion,which is helpful to maintain hemodynamic stability,and protect postoperative cognitive function.