无创连续血压监测下喉罩全麻患者应用长托宁与阿托品作为术前用药的对比分析

Comparative Analysis of the Preoperative Medication of Changtuoning and Atropine in Patients with Laryngeal Mask General Anesthesia under Non-invasive Continuous Blood Pressure Monitoring

目的探究长托宁与阿托品作为常用术前药物的各自优势,为临床术前用药提供参考依据。方法方便选取2020年1—6月期间接受腹腔镜手术喉罩全麻、ASAⅠ~Ⅱ级患者60例、年龄≤60患者,分为3组,每组20例。分别静注生理盐水2 mL(C组),阿托品0.01 mg/kg(A组),长托宁0.01 mg/kg(P组)。记录麻醉诱导前,拔除喉罩时气道分泌物的量;患者药物注射前(T0)、注药后5 min(T1)、注药后15 min(T2)、麻醉诱导后10 min(T3)、拔除喉罩时(T4),患者的心率(HR)、收缩压(SBP)、舒张压(DBP);停药后丙泊酚总用量,并计算单位时间内单位体质量丙泊酚的用量。结果术毕拔除喉罩时,3组患者气道分泌物分别为C组(23.6±6.2)mL、A组(10.7±3.0)mL、P组(5.2±2.2)mL,3组患者分泌物差异有统计学意义(P<0.05)。3组患者T0、T1、T2、T3时刻的HR分别为C组(76.2±9.6)、(75.5±10.1)、(76.4±9.5)、(60.2±7.5)bpm,A组(73.4±12.2)、(98.6±10.5)、(86.5±11.8)、(79.6±10.2)bpm,P组(75.1±10.8)、(77.2±11.1)、(76.2±10.2)、(61.1±8.6)bpm,3组患者血流动力学指标差异有统计学意义(P<0.05)。结论妇科喉罩全麻手术中,术前静推长托宁能有效抑制气道腺体的分泌,更好地稳定血流动力学,是非老年患者一种较为理想的麻醉前用药。

Objective To explore the advantages of Changtuoning and atropine as commonly used preoperative drugs,and to provide a reference for clinical preoperative medication.Methods Conveniently selected from January to June 2020,elective laparoscopic surgical laryngeal mask general anesthesia,60 patients with ASA I to II,age≤60.Divided into three groups with 20 cases in each group.Inject 2 mL of normal saline(group C),0.01 mg/kg of atropine(group A),and 0.01 mg/kg of Changtoning(group P).Record the amount of airway secretions when the laryngeal mask is removed before induction of anesthesia;patients before drug injection(T0),5 minutes after drug injection(T1),15 minutes after drug injection(T2),10 minutes after induction of anesthesia(T3),and laryngeal removal when masking(T4),the patient's heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP);the total dosage of propofol after drug withdrawal,and calculate the dosage of propofol per unit weight per unit time.Results When the laryngeal mask was removed after the operation,the airway secretions of the three groups were(23.6±6.2)mL in group C,(10.7±3.0)mL in group A,and(5.2±2.2)mL in group P,The secretion differences of the 3 groups were statistically significant(P<0.05).The HR at T0,T1,T2,and T3 of the three groups of patients were respectively(76.2±9.6)bpm,(75.5±10.1)bpm,(76.4±9.5)bpm,(60.2±7.5)bpm in group C,and(73.4±12.2)bpm,(98.6±10.5)bpm,(86.5±11.8)bpm,(79.6±10.2)bpm,P group(75.1±10.8)bpm,(77.2±11.1)bpm,(76.2±10.2)bpm,(61.1±8.6)bpm,there were statistically significant differences in hemodynamic indexes between the 3 groups(P<0.05).Conclusion In general anesthesia with gynecological laryngeal mask,preoperative intravenous injection of Changtonin can effectively inhibit the secretion of airway glands and better stabilize hemodynamics;it is an ideal pre-anaesthetic medication for non-elderly patients.