长托宁或阿托品与新斯的明合用拮抗肌肉松驰药残余作用时对血流动力学影响的比较  

Effects of penehyclidine hydrochloride or atropine combined with neostigmine for antagonizing residual neuromuscular block on patient's hemodynamics

作　　者：梁仕伟[1] 陈晔明[1] 

机构地区：[1]南方医科大学南方医院麻醉科,广东广州510515

出　　处：《第一军医大学学报》2005年第12期1581-1582,共2页Journal of First Military Medical University

摘　　要：目的观察长托宁或阿托品与新斯的明合用拮抗肌肉松驰其他药残余作用时对血流动力学的影响。方法择期上腹部手术成年病人80例,随机分为长托宁组和阿托品组,每组各40例。手术结束后5min,静脉注射新斯的明0.03mg/kg·b.w.、长托宁0.02mg/kg·b.w.或阿托品0.02mg/kg·b.w.拮抗残余的肌肉松驰其他作用。记录全麻诱导前5min、给药前1min及给药后2、5、10、15min各时点的心率、血压、呼气末二氧化碳分压(PETCO2)的变化。结果长托宁组给药前后的心率变化不大(P>0.05);阿托品组给药后心率显著增加(P<0.01),给药后15min时仍未恢复到给药前水平。在整个观察期间,两组血压和PETCO2无显著变化(P>0.05),组间比较也无显著性差异(P>0.05)。结论与阿托品比较,长托宁对心率、血压均无明显影响,而阿托品却使心率显著增快。Objective To investigate the effects ofpenehyclidine hydrochloride （PH）/atropine combined with neostigmine for antagonizing residual neuromuscular block on the hemodynamics. Methods Eighty patients with elective upper abdominal surgery were randomized equally into PH group and atropine group. Five minutes after the completion of surgery, PH 0.02 mg/kg （in PH group） or atropine 0.02 mg/kg （in atropine group） in combination with neostigime 0.03 mg/kg were given intravenously to reverse the residual neuromuscular block. The heart rate （HR）, mean arterial pressure （MAP） and end-tidal CO2 pressure （PETCO2 ） were recorded 5 min before anesthesia induction, 1 min before injection and 2, 5, 10, and 15 min after injection, respectively. Results During the investigation, HR in PH group did not undergo conspicuous changes （P〉0.05）. HR after the injection was markedly faster than that before the injection in atropine group （P〈0.01） and did not recover till 15 min after the injection （P〉0.05）. MAP and PE4202 showed no evident changes and no significant difference was observed between the two groups during the investigation （P〉0.05）. Conclusion Compared with atropine, PH does not obviously affect HR and BP, but atropine may accelerate HR.

关 键 词：长托宁 阿托品 新斯的明 神经肌肉阻滞 血流动力学 

分 类 号：R96[医药卫生—药理学]