长托宁用于胃肠恶性肿瘤根治术麻醉前准备的临床观察  

Investigation of penehyclidine hydrochloride as pre-anesthetic medication in gastrointestinal cancers

作　　者：黄贤君[1] 吴恺明[2] 肖亮灿[1] 牛丽君[1] 邬艳[1] 

机构地区：[1]中山大学附属第一医院麻醉科,广州510080 [2]中山大学附属第一医院胃肠胰外科,广州510080

出　　处：《消化肿瘤杂志（电子版）》2009年第2期118-121,共4页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的探讨选择性M-受体拮抗剂长托宁(盐酸戊乙奎醚)用于胃肠恶性肿瘤根治术麻醉前准备的临床效果。方法选取2009年4月～2009年6月胃肠恶性肿瘤根治术63例,其中胃癌21例,结肠癌42例;随机分为3组(每组21例,胃癌7例,结肠癌14例,胃癌:结肠癌=1:2):对照组(Ⅰ组),不应用术前药;阿托品组(Ⅱ组)和长托宁组(Ⅲ组)。Ⅱ组和Ⅲ组患者分别于麻醉诱导前30分钟肌肉注射阿托品0.01 mg/kg或长托宁0.01 mg/kg,记录用药气管插管后5分钟、1小时、2小时至术毕拔管时气道分泌物量、心率和血压。结果各监测时段,Ⅱ组患者的心率明显高于Ⅲ组和Ⅰ组,差异有统计学意义(P<0.05)。诱导前至气管插管后2小时,Ⅱ组和Ⅲ组患者的气道分泌物明显少于Ⅰ组(P<0.05)。术毕拔管时,Ⅱ组患者的气道分泌物则多于Ⅲ组(P<0.05)。结论选择性新型M-受体拮抗剂长托宁能有效控制麻醉患者的气道分泌物,且不引起心率增快,作为胃肠恶性肿瘤根治术麻醉前用药临床效果优于阿托品。Objective To investigate the clinical effect of administration of Penehyclidine Hydrochloride,a selective antagonist on receptor-M,as pre-anesthetic medication in radical surgery of gastrointestinal cancer.Methods Sixty three cases of gastrointestinal cancer from Apr.2009 to Jun. 2009 were involved,among which 21 cases received radical gastrectomy,42 cases received radical colectomy.Patients were randomly divided into 3 groups(7 cases of gastrectomy and 14 cases of colectomy in each group).There was no pre-anesthetic administration in Group I(control group,n=21). The patients in GroupⅡ(atropine group,n=21) and groupⅢ(penehyclidine hydrochloride group,n= 21) received atropine or penehyclidine hydrochloride injected muscularly with 0.01 mg/kg 30 minutes before anesthesia induction,respectively.The volume of secretion in airway,heart rate and blood pressure after administration were recorded from 5 minutes,1 hours,2 hours after intubation to extubation.Results After administration,the heart rate increased significantly in groupⅡthan that in groupⅠand groupⅢ(P<0.05).The volumes of secretion in airway in groupⅡand groupⅢwere significandy less than that in groupⅠwithin 2 hours before intubation(P<0.05).However,after extubation,the volume of secretion in airway in groupⅡwas much more than that in groupⅢ(P<0.05).Conclusion Administration of penehyclidine hydrochloride can reduce the secretion in airway without increasing heart rate,which is more effective than atropine as pre-anesthetic medication in gastrointestinal cancer patients.

关 键 词：盐酸戊乙奎醚 胃肠恶性肿瘤 麻醉前用药 

分 类 号：R614[医药卫生—麻醉学]