摘要
目的观察盐酸戊乙醛醚(长托宁)在腹腔镜手术中对患者的唾液分泌、口干程度、血流动力学以及肌松拮抗等的影响。方法40例腹腔镜择期手术病人,随机分为长托宁组(Ⅰ组)和阿托品组(Ⅱ组)。在麻醉方法、腹腔镜CO2气腹压力等相同条件下,分别于麻醉前静注和术终时与新斯的明配伍静注。观察并记录:1)于麻醉前的注药前与注药后15 min时的唾液分泌量和口干程度情况以及血流动力学变化。2)于术终的注药前、注药后1 min、5 min、15 min各时点的血流动力学变化和肌力的变化。结果1)麻醉前用药中,Ⅰ、Ⅱ组注药后15 min唾液分泌量明显减少,口干程度明显高于注药前,与用药前比较有显著性差异(P<0.01);两组间比较无显著性差异(P>0.01);MAP、SpO2无显著性差异(P>0.05);HRⅠ组无显著性差异(P>0.01),Ⅱ组与注药前相比有显著性差异(P<0.01),组间比较也有显著性差异(P<0.01)。2)术终用药中,Ⅰ组HR无显著性差异(P>0.05),Ⅱ组有一过性显著增加(P<0.05),15 min后趋于减慢;MAP、SpO2与注药前无显著性差异(P>0.05);肌力较注药前显著增加(P<0.05),但组间同一时点无显著性差异(P>0.05)。结论长托宁可作为替代阿托品的麻醉前用药,具有安全性和有效性;可与新斯的明配伍用于肌松拮抗更佳。
Objective To observe the effects of penehyelidine hydrochloride on salivary secretion, VAS of thirst, hemodynamics of the patients and neostigmine in laparoscopic operation. Methods 40 patients who would undergo laparoscopic operation were randomly divided into two groups, group of penehyclidine hydrochloride （group Ⅰ ） and group of atropine（group Ⅱ）. Under the circumstances of the same method of anesthesia and the same pressure of CO2 aero peritoneum, two drugs were i. v. on pre-induction and end-of-operation with neostigmine respectively. Record： 1. Pre-induction, before and after medication 15 minutes salivary secretion, VAS of thirst, hemodynamics of the patients; 2. end-of -operation, before and after dosage 1,5,15 minutes hemodynamics and muscle strength. Results 1. Pre- induction, the salivary secretion of the patients of group Ⅰ and group Ⅱ decreased apparently and VAS of thirst increased on 15min after medication, and there was significant deviation between after medication and before medication （P〈 0.01）. But, there was no significant deviation between the two groups （P 〉0.01）. MAP,SpO2 of the patients of group Ⅰ and group Ⅱ did not change apparently （P 〉 0.05）. The HR of the patients of group Ⅰ did not change apparently （P 〉 0.01）, but there was significant deviation in the HR of the patients of group Ⅱ after medication and before medication （P 〈 0.01）, and there was significant deviation between the two groups （P 〈 0.01）. 2. End of operation, the HR of the patients of group I did not change apparently （P 〉 0.05）, but there was transiently significant deviation in the HR of the patients （P 〈 0.05）, and after 15min steady; MAP,SpO2 of the patients of group Ⅰ and group Ⅱ did not change apparently after medication and before medication. Muscle strength significantly rose after medication than before medication （P 〈 0.05）, but, group Ⅰ and group Ⅱ did not change apparently （P 〉 0.05）. Conclusions 1. Penehyclidine Hydrochloride may be substituted atropine as premedication, safely and definitely. 2. Penehyclidine Hydrochloride and neostigmine as drug combination have better effects.
出处
《齐齐哈尔医学院学报》
2009年第2期138-139,145,共3页
Journal of Qiqihar Medical University
关键词
盐酸戊乙醛醚
阿托品
新斯的明
腹腔镜
CO2气腹
Penehyclidine Hydrochloride Atropine Neostigmine Laparoscopic CO2 Aeroperitoneum
