盐酸戊乙奎醚在老年心肌缺血患者肌松拮抗中的应用  

Penehyclidine hydrochloride mediated as antagonist of muscle relaxant in aged with myocardial ischemia

作　　者：崔剑[1] 陶国才[1] 邓安智[1] 曾子洋[1] 

机构地区：[1]第三军医大学西南医院麻醉科,重庆400038

出　　处：《第三军医大学学报》2006年第16期1718-1720,共3页Journal of Third Military Medical University

摘　　要：目的探讨盐酸戊乙奎醚在老年心肌缺血患者肌松拮抗中的优势及安全性。方法60岁以上术前心电图提示有心肌缺血的患者60例,随机分为阿托品(15μg/kg)+新斯的明组(40μg/kg)(A组),单纯盐酸戊乙奎醚组(20μg/kg)(B组)及盐酸戊乙奎醚(20μg/kg)+新斯的明组(40μg/kg)(C组),采集拮抗剂使用前后的心率变异指数等指标以了解其对生命体征的影响。结果所有患者均平稳度过手术麻醉期,在肌松拮抗剂使用后A组患者的心率增快、心率变异指数增加、呼吸变浅变快,B组患者心率轻度增快,但肌松恢复较缓慢,脑电双频指数(BIS)值升高延缓,C组心率轻度减慢,心率变异性最小,肌松恢复迅速无再抑制,呼吸变为慢而深,BIS值恢复延缓。结论盐酸戊乙奎醚复合新斯的明适合应用于老年性心肌缺血患者的肌松拮抗。Objective To investigate the advantage and safety of penehyclidine hydrochloride as the antagonist of muscle relaxant in aged patients with myocardial ischemia. Methods Sixty cases over 60 years old with myocardial ischemia in ECG were randomized to receive 15 μg/kg atropine ＋40 μg/kg neostigmine （group A）, sole 20 μg/kg penehyclidine hydrochloride （group B）, 20 μg/kg penehyclidine hydrochloride ＋40 μg/ kg neostigmine （ group C）. Vital signs of antagonism were observed before and after the changes of antagonism. Results All cases had an uneventful anesthesia and operation. After antagonists were administered, heart rate and heart rate variation index increased, respiration became shallow and faster in group A. The heart rate in group B only increased mildly and the muscle tone returned very slowly as the increasing of BIS. The signs were the most desirable such as mildly lower heart rate, the minimal heart rate variation index, faster recover of muscle tone without re-relaxation, slow and deep respiration, and slowly recovered BIS. Conclusion Penehyclidine hydrochloride combined with neostigmine is suitable to reverse the muscle relaxant in aged with myocardial ischemia.

关 键 词：肌肉松弛剂 盐酸戊乙奎醚 拮抗剂 心肌缺血 

分 类 号：R542.2[医药卫生—心血管疾病] R614[医药卫生—内科学]